INFECTOLOGIA CLINICA KUMATE PDF

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For those who did not know him, this portrayal presented at the National Academy of Medicine on April 29, will provide an overview of the man who lived the different areas of his life in an intense manner. He was descended from a family of rural origin that was his reason for pride and presumption. He also completed the program of Master of Public Health where he absorbed the style of critical analysis of health services from Dr.

In collaboration with Dr. He managed more than scientific publications, plus having disciples in Mexico and Latin America. The relationship with Dr. Over the next 46 years we worked continuously, even when for some periods we worked in different institutions.

Our relationship developed from student to attending physician, co-workers, boss and friends. We shared unforgettable experiences, battles in his terms, both in medical care as well as in teaching and research.

For analysts of public health, it can be interpreted as the sum of individual efforts that gradually introduced positive changes in the health policies of Mexican society. From an anthropological and social point of view, it can be constituted as a testimony of the impact of demographic and economic changes in the country on families as social units, which receive or undergo changes over time.

Gutierrez was characterized by his creativity and commitment to pediatric health. His strength of character and his tough and critical personality as well as his professional honesty facilitated many of his professional successes but also met with some frustrations to assume positions he aspired, always wondering how to offer more to our society.

The past is only useful as a foundation for the future. Medical practice is often associated with reflections on professional experiences. It is very difficult to be a neutral observer of what happens to a patient, although psychiatrists affirm this. In the history of medicine, during all times and civilizations there are examples of medical writings, examples of good words such as the aphorisms of Hippocrates or Sommerset Maugham an essayist, novelist and playwright whose work has been the subject of several films.

Both were candidates for the Nobel Prize for Literature, they were nominated simultaneously but were not chosen. His professional training was in Medicine School, at the headquarters of Santo Domingo, before the massification of the university district in the historic center. There he had the opportunity to attend some sessions of the National College within two blocks.

The chairs of medical figures of his time are not substitutable for nominations to fill the increasing number of students. In his passage through graduate study, our new author was influenced by three characters of strong and very definite personality, speaking accurate, clear in their articles, with classical culture, extensive experience in the civil service product of persevering work, and connoisseurs of human beings in the choice of collaborators, students or associates.

His pediatric training provided with opportunities of the kind that test and qualify the character of a person. Fate, or his ability known by the executives, put him as the initiator of the following projects:.

To achieve this, he showed creativity of all kinds in the tasks in charge:. He was a pediatrician who lived firsthand in countries where health systems seem unethical but who have achieved success to improve health and resolve problems.

Private practice allowed him to meet the wealthy residents of Mexico. This never excited him, and he left it after 15 years of afternoon practice.

As a clinical researcher, epidemiologist and official, his publications were more than sufficient to have a proper curriculum for the National System of Investigators SNI. His book is well-written, genuine and interesting regarding life in Mexico in the years of peace without military uprisings , the stage of sustainable development and the first medical conflicts of , the tragic and the end of the majority party.

After reading his book, you would have an accurate description of the practice of medicine in Mexico; the strengths and weaknesses of what has been achieved and how much there is to do, especially in a country of opportunities, to achieve college education and postgraduate studies. It illustrates how, in our time, it is possible to form a family with 51 years of marital stability, educated children and grandchildren proud of their parents—a great man, husband and father, but mostly great friend and accomplice who was my beloved and admired Gonzalo.

When the shock of an irreparable event forces us to meditate; when the earthly investiture lies as ultimate expression of what it was; when the immeasurable transition between being and not being allows us to be more skeptical, I find the full reason for the passion that accompanied the Master, Dr. Multiple feelings were generated with his presence among us, which was respected and sometimes feared by the strictness and rigid attitude with which he handled the Service of Infectious Diseases of HP in the CMN IMSS.

Romantic, dreamy, charitable, feverish and extremely passionate, his love for the IMSS and, particularly, for his service, was recorded with chisel and hammer in the soul of each of us and will be floating through the infinite sea.

With his steady hand, his spartan attitude, often tough but loving, humane and highly constructive, it was a compass for those who were chiseled by him, having honored the career of Hippocrates, trying to imitate and faithfully follow the un-forgettable values he enabled and that made us, modesty aside, pediatricians in every sense of the word.

Life is short! He returned in recent years to his alma mater, the HIM, giving all his knowledge, experience and academic skills to the publication of its journal, an icon of Latin American pediatric literature.

To pay tribute to a wise teacher, a righteous man, a tireless cultivator of science, a persistent fighter against the forces of evil, human diseases, ignorance and injustice— knowing that while men act as this illustrious male honor and glory of this beautiful, fertile and brave land—our hope will not die, our faith enlivens and our confidence in the permanent spiritual values enlarge. Farewell Gonzalo, scientist, teacher and great friend who left amid the silent purity of authentic values.

Remembering, in addition to being a search to complete the farewell, if that is possible, is more an attempt to recreate or revive the legacy, the legacy Gonzalo left us, to see more clearly, to live it, use it and enjoy it better.

Gonzalo investigated, talked and wrote much of his origins. He used to find, in peasant roots on his paternal side, sources of pride, but many more in the great cultural leap that his father gave to avoid his apparent fate of becoming a farmer or priest. With work, but especially with strategy guided and driven by his mother, he accomplished a career in law, first in Guadalajara and then the Escuela Libre de Derecho in Mexico City. The family that she formed with Ricardo Trujillo was challenged by various diseases: three of their ten children were deaf and her husband died of a gastric ulcer.

She responded to these challenges with dedication and strategy that led the family to overcome based on the development of each individual. It is hard to imagine that she visualized a physician among her descendants as another form of struggle against adversity. Gonzalo was the physician of many in the family. As a pediatrician, he formed with the family a cohort itself: of course he cared for his three children and his 23 nephews and nieces, then much of the next generation of great-nephews and great-nieces.

He monitored their development and immunizations, an important element of preventive medicine and he was proud of the guarantee from the application to his patients to the design of national schemes. After a thorough assessment in a very large proportion of cases, the response to a distraught mother, including sisters, sisters-in-law and nieces, to relatively minor respiratory or gastrointestinal profiles was as follows:.

These responses proved to be a litmus test to define whether or not Gonzalo would continue as the pediatrician and actually how a cohort of families headed by mothers selected the evidence but were required to withstand the toughness.

However, these guidelines were part of his constant struggle every day: a fight for patients to contain antibiotic resistance, to curb the abuse of drugs, to curb the abuse of technology in medicine.

And he always made us part of his struggle. In children he saw the possibility of a better future. His job was to take care of that future. That is why he found that, as a group, children were often marginalized in their needs, their access to health, especially in their development possibilities. Thus, he found injustice against children. He had the need to combat using the institutions and to fight battles, which certainly he enjoyed, against simulation and bureaucracies that end up imposing interests outside their domain.

Gonzalo always commented on the books he was reading. Gonzalo wrote about death. He wrote about the death of friends. About how it happened, how they tried to avoid or facilitate it, or when it surprised them. In his latest internment, which occurred in CMN SXXI Hospital of Cardiology because of the problem which resulted to be his final event and knowing that the diagnosis was a massive pulmonary embolism, with great shortness of breath, he told us:.

They will infuse you with a substance to dissolve the thrombus. I had the opportunity to meet Gonzalo at an early stage of my life when I was a high school student, thanks to the Armendares family. Gonzalo was the pediatrician of my best friend, Pedro Enrique Armendares, son of Salvador Armen-dares, whom Gonzalo had a friendship of many years. From that experience, Gonzalo had my recognition and appreciation as a great master.

It was a good course that left a lasting imprint on my medical training. Subsequently, I renewed this friendship in the famous Club de la Cantina, convened by my beloved teacher and friend, Ruy Perez Tamayo. In recent years, we were able to have Gonzalo return for the monthly gatherings for friends where his energetic and always liberal views were appreciated.

I did not have the privilege of working directly with him, but I was blessed with his friendship and counsel in complex and difficult career stages, and like many of his colleagues, I did not run away from a great insult when contradicted.

Gonzalo had the talent and intelligence to transform the health of millions of Mexicans with his ideas and through his work. Infectious disease pediatrician and public health specialist—using a term in which he framed his occupation—he graduated from the School of Public Health of Mexico in , and since then he took the name of our school.

Gonzalo left us a great legacy in different areas of medicine. This was reflected, among other areas, in scientific and popular papers in national and international journals as well as chapters in medical books and various technical manuals. I would like to refer in particular to his contribution in the area of public health.

Gonzalo played a significant role in controlling measles epidemic in and cholera epidemic in Under his leadership the implementation of the first three doses of DPT vaccine were replaced by the pentavalent whole cell vaccine, and during his tenure at the CONAVA pushed training in integrated care to children 5 years of age through training at state and regional centers.

The activities of these reflected more the relative importance and authority levels of the managers responsible for each program than institutional or public health priorities. Beyond the anecdote, and in recognition of the critical thinking that always characterized him, it is fair to say that Gonzalo was aware not only of the complexity of the dislocation, but also the implied difficulty in communicating the importance of preventive activities or health promotion both to workers and to the population.

How do you motivate employees? How do you motivate people to carry out tasks related to health care? These were questions that intensely occupied him during the years of creation, design and implementation of PrevenIMSS. In response to these questions and under his leadership, the idea of integrated health programs was generated, an approach that not only facilitated the integration of programs and workers in joint actions, but also the empowered and informed participation of the population.

Thus, more than 30 programs that were developed in the IMSS were grouped into a logical framework of actions throughout life and in five integrated health programs:. The idea held by Gonzalo was that integrated health programs result in the promotion of health, nutrition, prevention and reproductive health among the population by means of an instrument of empowerment: the health booklet.

Health booklets became a clear and accessible educational tool, mainly to the beneficiaries. Because the health booklet empowers persons to take charge of their health, special emphasis was given to the reported delivery.

Booklets were the instrument where the responsibilities of the program were expressed and where the beneficiares could verify its compliance. Launching of the booklets was accompanied by numerous operating manuals and training for physicians and nurses in the workforce of PrevenIMSS.

Quick-witted, all watched the screen filled with meaning to which it was easy to contribute, not only because he knew how to lead but also because his strong personality made impossible to have distractions and a passive attitude.

Program interventions were selected based on criteria of magnitude, transcendence, vulnerability and feasibility. The national regulatory personnel responsible for public health programs and the 37 delegations of the Institute participated in the design of the program. The health booklets were developed and delivered to the beneficiaries, self-help groups were organized and an important media campaign was launched to promote services related to PrevenIMSS and the participation of the population.

Under the guidance and leadership of Gonzalo, institutional statistical information systems were also modernized and the manner to register actions was changed: from the traditional checkmark to register the name of each beneficiary.

This enabled the estimation of coverage of preventive actions by the family, medical unit and registration of participants. Gonzalo was a tireless public health professional whose experience and achievements make us remember the great value of public health.

Without a doubt, he was a champion of public health and his life is a model for future generations of health professionals.

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