Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/alerpma/public_html/libraries/rokcommon/RokCommon/Service/ContainerImpl.php on line 454

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokextender/rokextender.php on line 32

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokgallery/rokgallery.php on line 22

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokgallery/rokgallery.php on line 23

Strict Standards: Non-static method RokCandyHelper::getMacros() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/plugins/system/rokcandy/rokcandy.php on line 28

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 13

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 14

Strict Standards: call_user_func_array() expects parameter 1 to be a valid callback, non-static method RokCandyHelper::getUserMacros() should not be called statically in /home/alerpma/public_html/libraries/joomla/cache/controller/callback.php on line 159

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 24

Strict Standards: Non-static method RokCandyHelper::getTemplateOverrides() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 18

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 41

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/administrator/components/com_rokcandy/helpers/rokcandy.php on line 42

Strict Standards: call_user_func_array() expects parameter 1 to be a valid callback, non-static method RokCandyHelper::readIniFile() should not be called statically in /home/alerpma/public_html/libraries/joomla/cache/controller/callback.php on line 159

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/jcemediabox/jcemediabox.php on line 331

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/jcemediabox/jcemediabox.php on line 136

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokbox/rokbox.php on line 51

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokcandy/rokcandy.php on line 67

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokcandy/rokcandy.php on line 37

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/gantry.php on line 421

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Declaration of LikeWhereClause::testRow() should be compatible with WhereClause::testRow($row, $rowSchema = NULL) in /home/alerpma/public_html/libraries/gantry/core/gantryflatfile.class.php on line 662

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/gantry.php on line 188

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/gantry.php on line 189

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Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 205

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1085

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1085

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Declaration of GantryParamProcessorAlias::postLoad() should be compatible with GantryParamProcessor::postLoad(&$gantry, $param_name, &$param_element, &$data, $value) in /home/alerpma/public_html/libraries/gantry/core/params/processors/alias.php on line 17

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/utilities/gantrycache.class.php on line 70

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 321

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 324

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 337

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 337

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantrySessionParamOverride::populate() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1239

Strict Standards: Non-static method GantryCookieParamOverride::populate() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1240

Strict Standards: Non-static method GantryMenuItemParamOverride::populate() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1243

Strict Standards: Non-static method GantryMenuItemParamOverride::_populateSingleItem() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 36

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 54

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 54

Strict Standards: Non-static method GantryMenuItemParamOverride::_populateSingleItem() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 36

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 54

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/params/overrides/gantrymenuitemparamoverride.class.php on line 54

Strict Standards: Non-static method GantryUrlParamOverride::populate() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1246

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 1053

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/features/inactive.php on line 31

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/features/inactive.php on line 31

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/features/pagesuffix.php on line 38

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/includes/application.php on line 536

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/features/pagesuffix.php on line 38

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/plugins/system/rokgallery/rokgallery.php on line 53
¿Qué es un espirómetro?

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryModulesRenderer::display() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 680

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/features/systemmessages.php on line 26

Strict Standards: Only variables should be passed by reference in /home/alerpma/public_html/libraries/gantry/core/renderers/gantrymodulesrenderer.class.php on line 81

Strict Standards: Only variables should be passed by reference in /home/alerpma/public_html/libraries/gantry/core/renderers/gantrymodulesrenderer.class.php on line 82

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Non-static method GantryLoader::import() should not be called statically in /home/alerpma/public_html/libraries/gantry/gantry.php on line 40

Strict Standards: Non-static method GantryModulesRenderer::display() should not be called statically, assuming $this from incompatible context in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 680

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

Strict Standards: Only variables should be passed by reference in /home/alerpma/public_html/libraries/gantry/core/renderers/gantrymodulesrenderer.class.php on line 81

Strict Standards: Only variables should be passed by reference in /home/alerpma/public_html/libraries/gantry/core/renderers/gantrymodulesrenderer.class.php on line 82

Strict Standards: Only variables should be assigned by reference in /home/alerpma/public_html/libraries/gantry/core/gantry.class.php on line 489

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espirometro

Un espirómetro o medidor de flujo pico para el asma es como un termómetro para la fiebre. Es un aparato que le ayuda a vigilar lo que sucede dentro de su organismo. A veces, cuando usted no se siente bien y le parece que está afiebrado o acalorado, se toma la temperatura con un termómetro, pero los valores le dan normales. En el caso del asma, a veces usted puede creer que está respirando bien pero si se mide con un espirómetro, podrá ver que la función pulmonar está ligeramente reducida. Un espirómetro ayuda a determinar los cambios en las vías respiratorias y a controlar mejor el asma.

Uso del espirómetro

Un espirómetro es un aparato sencillo, portátil y económico que mide el flujo de aire o la tasa de flujo espiratorio pico (tasa FEP). Los asmáticos soplan dentro de este aparato rápido y con fuerza. Así se obtiene una lectura de flujo pico que indica cuán abiertas están las vías respiratorias o cuán difícil es respirar. Si se usa de manera apropiada, un espirómetro puede ser un valioso instrumento para controlar el asma. Sirve como herramienta para:

  • Determinar la severidad del asma
  • Constatar su respuesta al tratamiento durante un episodio de asma agudo
  • Supervisar el progreso del tratamiento del asma crónico y proporcionar información objetiva sobre los posibles ajustes en la terapia
  • Detectar el empeoramiento de la función pulmonar y evitar así una fuerte crisis de asma mediante una intervención oportuna.
  • Evaluar la severidad del asma

Una de las funciones más importantes del espirómetro es permitirle a usted y su médico evaluar la gravedad del asma. Usted verá un descenso en las lecturas de flujo pico incluso antes de que los síntomas del asma (como tos o respiración sibilante) empeoren. La disminución en el flujo pico puede indicar que tal vez deba aumentar la dosis del medicamento. Cuanto antes se detecte un signo de advertencia, más temprano se podrá hacer frente al problema.

Puede ser muy útil conocer su flujo pico si tiene que llamar al médico fuera de hora porque los síntomas aumentaron. El valor del flujo pico le brinda al médico un panorama mejor sobre cómo le está yendo a usted y cómo responde al tratamiento en casa.

Otra medida del control del asma es la variabilidad de flujo pico. Una persona que no tiene asma o que tiene bien controlado el asma soplará de manera constante flujos pico con una variación inferior a 15%. La mayoría de los asmáticos sabe que los síntomas del asma por lo general empeoran de noche. Un espirómetro es útil para controlar la severidad del asma a esas horas. Una reducción del 15% o mayor con respecto a la medición de la noche anterior puede indicar la presencia de asma nocturno. Esto puede indicar si el asma está bien controlado o no.

Cómo usar el espirómetro

Para usar un espirómetro como es debido, hay que seguir varios pasos. Debe soplar con fuerza dentro del medidor para obtener la mejor lectura posible y efectuar tres veces este procedimiento. Anotar el mejor de los tres intentos. El trío de mediciones debe dar más o menos lo mismo, demostrando que en todos los intentos se hicieron los mejores esfuerzos. Esto es particularmente importante cuando los padres controlan el asma en sus hijos.

Siga los siguientes pasos generales al usar un espirómetro:

  • Verifique que el aparato está en cero o en el nivel base
  • Párese (a menos que tenga una discapacidad física)
  • Inspire lo más profundo que pueda
  • Coloque el medidor en la boca y apriete la boquilla con los labios
  • Sople lo más fuerte y rápido que pueda (entre uno y dos segundos)
  • No tosa, escupa ni deje que la lengua obture la boquilla
  • Anote el valor obtenido
  • Repita el proceso dos veces más y anote el valor más alto de los tres en su registro

Su médico tal vez le pida que registre el flujo pico antes y después de usar el inhalador. Si la medicina le está haciendo efecto, deberá ver una mejoría en la lectura del flujo pico. Lleve una tabla con las lecturas del flujo pico, anotando cada día en una columna para poder ver cómo están los síntomas del asma. Con frecuencia, con el aparato vienen gráficos para trazar las lecturas de flujo pico y se pueden fotocopiar para usarlos con regularidad.

Los medidores de flujo pico requieren ciertos cuidados, por lo tanto recuerde de seguir las instrucciones para su limpieza que acompañan el equipo. Esto contribuye a asegurar su precisión.

Cómo determinar cuál es la mejor lectura para Ud

Aunque el flujo pico "normal" previsto para usted está determinado por la altura, la edad y el sexo, es preferible calibrar el control del asma efectuando comparaciones de los registros diarios de flujo pico con su "mejor medición personal". La mejor medición personal de flujo pico es el valor más alto de flujo pico que un paciente puede obtener en un período de 2 a 3 semanas, cuando tiene bajo control el asma.

Para determinar el mejor valor para usted:

  • Use siempre el mismo espirómetro
  • Anote el flujo pico dos veces al día durante dos semanas
  • Ignore los valores distantes

Los mejores valores personales varían a medida que un niño crece y cambia el estatus de la enfermedad. Su médico efectuará ajustes periódicos de sus mejores valores personales.

El sistema del semáforo

Una vez que usted y su especialista en alergias o inmunólogo hayan establecido el flujo pico que más le convenga, usted deberá hacer todo lo posible por mantener los valores dentro del 80% de este valor, para que se sienta en condiciones óptimas. Puede utilizar como una guía sencilla el siguiente sistema del semáforo:
Verde-Tasa de flujo espiratorio pico (Tasa FEP) 80-100% del mejor valor personal.

Todos los sistemas "Pasan". Usted prácticamente no tiene síntomas y puede mantener su actual programa de control de asma. Si está bajo medicación continua y el flujo pico está constantemente en la zona verde con una variación mínima, su médico puede considerar una reducción gradual de la dosis diaria de medicamento.

Amarillo-Tasa FEP 50-80% del mejor valor personal. "Atención", el asma está empeorando. Se indica el aumento temporal de la medicación del asma. Si está bajo medicamento crónico, tal vez tenga que aumentar la terapia de mantenimiento. Contacte a su médico para ajustar la terapia.

Rojo-Tasa FEP por debajo del 50% del mejor valor personal. "Peligro", usted no puede dominar el asma y el programa de tratamiento no está controlando los síntomas. Use el broncodilatador inhalado. Si las lecturas del flujo pico no retornan por lo menos a la zona amarilla, contacte a su especialista en alergias o inmunólogo, quien le ayudará a emplear una terapia agresiva. Deberá aumentar la terapia de mantenimiento.

Estas zonas del semáforo son lineamientos generales diseñados para simplificar el control del asma. El buen control del asma depende de una buena relación entre el paciente y el médico. La comunicación abierta y el intercambio de información pueden ser mejorados controlando el flujo pico y anotando sus valores. El médico puede usar estos datos para diseñar y ajustar la dosis de medicamento para que usted pueda controlar el asma lo mejor posible.


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Banner Contraste 1

Enlaces


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 logo asociacion alegologia

Revistas ACAAI

 

Revistas Clinicas

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Contacto


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Email: Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo.
Tel. (507)
503-6373 Paulo
       (507) 503-6367 Manuel



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logo alegologia

Redes Sociales


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redes


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