Cáncer Gástrico y Helicobacter Pylori: Un Problema de Salud Pública

7/25/2019 Cncer Gstrico y Helicobacter Pylori: Un Problema de Salud Pblica.

1/20

!"#!$% '"()%*!+ ,-$.*!+/0!)$% 1,.+%*2

3# 1%+/.$40 5$ (0.35

16/.*!0

/$#$47%*)0 3#*8$%(*505 03)+#+40 5$13$/.090!3.)05 5$ 4$5*!*#05$(0%%+..+ 5$ -0/*.*505$( 5$ .0)$!#+.+':0 ; .0 *#9+%40!*


2/20

!"#$%&

()*+,-./012/3,4 56-04.

7)*+,-./012/3,4 56-04. 6 %89/,4 :8;34./0 ,9 ./0

7)7)*?4.@,9 6 %09;,/A,9/.2;

7)B)*


3/20

$"JL?#M%%$N"

$B CDEFEGHE CDIJEKHI EFHL MNDNONMI P BP CIQBPKNRG EG OEGEDPB; KIG EB SNG ME KDEPD KIGKNEGKNP FIQDE

TG HEUP VTE EG BIF WBHNUIF PXIF YP NMI OPGPGMI DEBEZPGKNP CID BPF DECEDKTFNIGEF VTE YP HEGNMI

EG EB FNFHEUP ME FPBTM UE[NKPGI\ #TEFHDI IQ]EHNZI CDNUPDNI EF NGSIDUPD PB NGHEDEFPMI; FEP I GI

CDISEFNIGPB MEB LDEP ME BP FPBTM; FIQDE BP GPHTDPBE^P ME BP YEBNKIQPKHED CJBIDN; PF_ KIUI BPF

KIGFEKTEGKNPF VTE CTEME HEGED TGP NGSEKKNRG MEFKIGHDIBPMP MEB UNFUI UNKDIIDOPGNFUI\ (EEFCEDP VTE EB CDEFEGHE HE[HI BIODE KIGKNEGHN^PD; I FNDZP KIUI TGP FEXPB ME PBEDHP CPDP EB BEKHID;

CPDP VTE ME `FHP UPGEDP KIGI^KP J BIODE CDEZEGND EG BP UE]ID UEMNMP CIFNQBE KNDKTGFHPGKNPF

MEFSPZIDPQBEF CPDP BP FPBTM KIUI BI FIG BPF VTE FE CDEFEGHPG P BI BPDOI ME `FHE HDPQP]I\ $F EFHP

BP DP^RG CID BP KTPB FE HDPHPDL ME GI THNBN^PD HEDUNGIBIO_P U`MNKP EG PQTGMPGKNP; EFCEDPGMI PF_

VTE BP NGSIDUPKNRG E[CTEFHP FEP BI UE]ID KIUCDEGFNQBE CIFNQBE\ )PUQN`G FE NGKBTJEG EG `FHE

HDPQP]I HEFHNUIGNIF DEPBEF DESEDEGHEF PB HEUP\ (E EFCEDP VTE BP MNFCIFNKNRG EFHDTKHTDPB; EG OEGEDPB

SPKNBNHE I ZTEBZP PUEGP BP BEKHTDP; J VTE GI FE HICE EB BEKHID KIG KIGHEGNMI FPHTDPMI I MNS_KNB ME

KIUCDEGMED\


4/20

#&GOLL?PP?

a\b -EBNKIQPKHED 1JBIDN

1PDP MPD TGP ODPG NMEP KBPDP PKEDKP MEB HEUP P HDPHPD; CDNUEDI EF GEKEFPDNI MEFKDNQND KIUI HPB P

BP CDNGKNCPB QPKHEDNP KPTFPGHE ME UTKYPF EGSEDUEMPMEF OPFHDINGHEFHNGPBEF\

$G CDNUED H`DUNGI; BP YEBNKIQPKHED CJBIDN EF TGP QPKHEDNP EG SIDUP ME EFCNDPB VTE KDEKE EG BP KPCP

UTKIFP VTE DEKTQDE EB NGHEDNID MEB EFHRUPOI YTUPGI\ 1PDP FIQDEZNZND EG `FHE UEMNI YIFHNB J

LKNMI MNKYP QPKHEDNP FEKDEHP TGP EG^NUP BBPUPMP TDEPFP; BP KTPB KIGZNEDHE BP TDEP VT_UNKP EG

PUIGNPKI\ .P CDIMTKKNRG ME PUIGNPKI PBDEMEMID ME BP QPKHEDNP; GETHDPBN^P BP PKNME^ MEB

EFHRUPOI; CPDP YPKEDBI ULF PKIOEMID; PMEULF BP SIDUP ME EFCNDPB ME `FHP QPKHEDNP; BE CEDUNHE

CEGEHDPD BP KPCP UTKIFP; BP KTPB EF UEGIF LKNMP VTE EB EFCPKNI NGHEDNID I BTUEG; PTGVTE HPUQN`G

CTEME PMYEDNDFE P BPF K`BTBPF VTE DEZNFHEG BP FTCEDSNKNE NGHEDGP MEB EFHRUPOI\

1ID IHDP CPDHE; BPF K`BTBPF NGUTGNHPDNPF DEKIGIKEG J PHPKPG GIDUPBUEGHE P BPF QPKHEDNPFNGZPFIDPF; `FHPF FE PKTUTBPG KEDKP ME BIF FNHNIF ME NGSEKKNRG CID YEBNKIQPKHED; BI VTE BEF NUCNME

CIMED BBEOPD PB DEZEFHNUNEGHI MEB EFHRUPOI\ 0MEULF MNKYP QPKHEDNP KDEP UEMNIF ME NGHEDZEGKNRG

EG BPF DEPKKNIGEF NGUTGNHPDNPF BIKPBEF; BI VTE BPF YPKE NGESNKPKEF CPDP VTE BP EBNUNGEG\


5/20

$B UIMI ME HDPGFUNFNRG ME BP YEBNKIQPKHED PWG GI EF CBEGPUEGHE KIGIKNMI; CEDI FE FPQE VTE

CTEME IKTDDND ME TGP CEDFIGP KIGHPUNGPMP P TGP FPGP CID UEMNI MEB KIGHPKHI KIG ZRUNHIF I

YEKEFc EG EB KPFI ME BPF YEKEF OEGEDPBUEGHE QP]I BP SIDUP ME POTP I PBNUEGHIF KIGHPUNGPMIF\

.IF FEDEF YTUPGIF CPDEKEUIF FED EB DEFEDZIDNI GPHTDPB ME BP QPKHEDNP; CID BI VTE KTPGMI TG

UNEUQDI ME BP SPUNBNP FE NGSEKHP; EB DNEFOI ME HDPGFUNFNRG CPDP BIF YN]IF J KIGJTOTE EF PBH_FNUI\

7FHP HDPGFUNFNRG EF KIUWG NGKBTFI EG KPFPF KIG QTEGPF KIGMNKNIGEF ME YNONEGE\

.P CDEFEGKNP ME YEBNKIQPKHED KPTFP BEFNRG EG EB EFHRUPOI J EG EB MTIMEGI; EFHPGMI PF_ PFIKNPMI

KIG TG UPJID DNEFOI ME2

d 'PFHDNHNF

d 5TIMEGNHNF

d 6BKEDP ME MTIMEGI

d 6BKEDP ME EFHRUPOId .NGSIUP ME EFHRUPOI

d !LGKED 'LFHDNKI

.P ODPG UPJID_P ME BIF CPKNEGHEF KIGHPUNGPMIF CID YEBNKIQPKHED GI CDEFEGHPG GNGOWG HNCI ME

F_GHIUP I KIUCBNKPKNRG\ $[NFHEG KECPF EG BP QPKHEDNP ULF PODEFNZPF J KECPF ULF NGMIBEGHEF; BI

KTPB E[CBNKP EG CPDHE BP IKTDDEGKNP ME F_GHIUPF EG CIKPF CEDFIGPF KIGHPUNGPMPF\ $F NUCIDHPGHE

MEFHPKPD VTE BP QPKHEDNP; EG F_; EF PFNGHIULHNKP\ .IF CPKNEGHEF PSEKHPMIF VTE CDEFEGHPG VTE]PF

BI YPKEG CID BP CDEFEGKNP ME OPFHDNHNF I WBKEDPF C`CHNKPF CDIZIKPMPF CID BP UNFUP\ $G FHIF KPFIF

BIF F_GHIUPF ULF KIUTGEF FIG2

d 5IBID I NGKIUIMNMPM; OEGEDPBUEGHE CDEFEGHPMI KIUI VTEUP^RG EG BP CPDHE FTCEDNID ME

PQMIUEG\

d (EGFPKNRG ME YNGKYP^RG MEB EFHRUPOI\

d (PKNEMPM DLCNMP MEB YPUQDE; OEGEDPBUEGHE MEFCT`F ME KIUED TGP CEVTEXP KPGHNMPM ME

PBNUEGHI\

$G EB KPFI ME WBKEDPF; BPF FNOTNEGHEF FEXPBEF J F_GHIUPF HPUQN`G FIG KIUTGEF2

b #PTFEPF I ZRUNHIF

b -EKEF IFKTDPF

b 0GEUNP

1PDP CDEZEGND NGSEKKNIGEF CID YEBNKIQPKHED CJBIDN EF GEKEFPDNI HIUPD BPF FNOTNEGHEF UEMNMPF ME

CDEZEGKNRG2


6/20

d .PZPDFE BPF UPGIF MEFCT`F ME TFPD EB QPXI J PGHEF ME KIUED\

d !IUED PBNUEGHIF CDECPDPMIF PMEKTPMPUEGHE\

d /EQED POTP ME STEGHEF BNUCNPF J FEOTDPF\


7/20

e\b -EBNKIQPKHED 1JBIDN J !LGKED 'LFHDNKI EG 4`[NKI

$B KLGKED ME EFHRUPOI FE KIGIKE KIUI KLGKED OLFHDNKI; J EB PMEGIKPDKNGIUP OLFHDNKI; EF EB ULF

KIUWG ME BIF KLGKEDEF EG EB EFHRUPOI VTE FTDOE ME BPF K`BTBPF ECNHEBNPBEF KIBTUGPDEF; BPF

KTLBEF DEZNFHEG BP FTCEDSNKNE MEB UNFUI RDOPGI\ 1EDI EG KTPGHI P EBBI; EF FTUPUEGHE NUCIDHPGHE

UEGKNIGPD VTE BP NGSEKKNRG CID BP QPKHEDNP YEBNKIQPKHED CJBIDN EF EB SPKHID ME DNEFOI CDNUPDNI

PFIKNPMI KIG EB KLGKED OLFHDNKI\ 5E YEKYI; FE KDEE VTE `FHP NGSEKKNRG KPTFP MEB >fg PB Afg ME

HIMIF BIF KLGKEDEF OLFHDNKIF\

.IF KLGKEDEF ME EFHRUPOI HNEGMEG P MEFPDDIBBPDFE BEGHPUEGHE CID UTKYIF PXIF; J PGHEF ME VTE

FE SIDUE TG ZEDMPMEDI KLGKED; P UEGTMI IKTDDEG KPUQNIF CDEKPGKEDIFIF EG EB DEZEFHNUNEGHI

NGHEDGI; EF MEKND; BP UTKIFP\ 7FHIF KPUQNIF KPFN GTGKP KPTFPG F_GHIUPF; J CID BI HPGHI GI FIG

MEHEKHPMIF P HNEUCI\

$G KTPGHI P BIF HTUIDEF KPGKEDIFIF FE CTEME MEKND VTE `FHIF KIUNEG^PG EG MNSEDEGHEF

FEKKNIGEF MEB EFHRUPOI\ 1IMD_PU CDIMTKND F_GHIUPF MNFHNGHIF J HNEGMEG P HEGED KIGFEKTEGKNPF


8/20

MNSEDEGHEF\ .P BIKPBN^PKNRG MEB KLGKED HPUQN`G CTEME PSEKHPD BPF ICKNIGEF ME HDPHPUNEGHI\ 1ID

E]EUCBI; BIF KLGKEDEF VTE FE IDNONGPG EG BP TGNRG OPFHDIEFISLONKP FIG HDPHPMIF J KBPFNSNKPMIF ME

BP UNFUP SIDUP VTE BIF KLGKEDEF ME EFRSPOI\

.IF KLGKEDEF ME EFHRUPOI FE CTEMEG CDICPOPD ME ZPDNPF UPGEDPF; `FHIF CTEMEG KDEKED P HDPZ`F

ME BP CPDEM MEB EFHRUPOI E NGZPMND BIF RDOPGIF KEDKPGIF\ )PUQN`G CTEMEG CDICPOPDFE P BIF

ZPFIF BNGSLHNKIF J P BIF OPGOBNIF PMJPKEGHEF\ !TPGMI EB KLGKED ME EFHRUPOI FE HIDGP ULF

PZPG^PMI; CTEME ZNP]PD P HDPZ`F MEB HIDDEGHE FPGOT_GEI J CDICPOPDFE P RDOPGIF KIUI EB Y_OPMI;

BIF CTBUIGEF J BIF YTEFIF\

QO%J?L&G #& L$&G:? #&P %R"%&L :RGJL$%?

3G SPKHID ME DNEFOI EF KTPBVTNED SPKHID VTE PTUEGHP BPF CDIQPQNBNMPMEF ME HEGED TGP EGSEDUEMPM;

KIUI EB KLGKED\ .IF MNFHNGHIF HNCIF ME KLGKED HNEGEG MNSEDEGHEF SPKHIDEF ME DNEFOI; J FE KBPFNSNKPG

ME BP FNOTNEGHE UPGEDP290!)+%$( 5$4+'%"9*!+( 04/*$#)0.$(

b EMPM PZPG^PMP

b O`GEDI UPFKTBNGI

b PBNUEGHPKNRG CIQDE EG SDTHPF J ZEDMTDPF

b PBNUEGHPKNRG PBHP EG FPB; KIUNMPF PYTUPMPF I EG KIGFEDZP

b HPQPVTNFUI

90!)+%$( /*+.


9/20

PSEKHP PCDI[NUPMPUEGHE PB fkg ME BP CIQBPKNRG UE[NKPGP; IDNONGPGMI EBEZPMPF KNSDPF ME

UIDQNBNMPM J UIDHPBNMPM\ .P NGSEKKNRG CID `FHP QPKHEDNP FE PMVTNEDE MTDPGHE BP NGSPGKNP J CEDFNFHE

KIUI OPFHDNHNF KDRGNKP FN BP QPKHEDNP GI EF EDDPMNKPMP\

!IG QPFE EG HIMIF BIF PDH_KTBIF EG BIF VTE NGZEFHNOPUIF; GIF CEDKPHPUIF VTE FE YP MEUIFHDPMI

VTE BP QPKHEDNP; PB FED NGOEDNMP CID TG NGMNZNMTI; KIBIGN^P BPF CPDEMEF MEB EFHRUPOI J CEDUPGEKE

EGHDE BPF K`BTBPF MEB DEZEFHNUNEGHI OLFHDNKI CDIMTKNEGMI NGSBPUPKNRG; CTEF CIFEE UEKPGNFUIF ME

MESEGFP EFCEKNPBEF VTE BE CEDUNHEG FIQDEZNZND EG EB UEMNI LKNMI VTE BP DIMEP\ (N P `FHP

NGSBPUPKNRG FE FTUP EB LKNMI J IHDIF SPKHIDEF PODEFNZIF; FE CDIMTKEG KTPMDIF KIUI OPFHDNHNF;

WBKEDPF;J EF EG MIGME MEFCT`F ME UTKYIF PXIF J EG CPKNEGHEF KIG CDEMNFCIFNKNRG OEG`HNKP FE

CTEME BBEOPD P MEFPDDIBBPD EB KLGKED OLFHDNKI\ 7FHP QPKHEDNP PKHTPBUEGHE EF KIGFNMEDPMP KIUI TG

POEGHE KPGKED_OEGI MEB EFHRUPOI\

e\ab +DNOEG J !IGFEKTEGKNPF

)PGHI KLGKED OLFHDNKI KIUI BNGSIUP YPG FNMI PFIKNPMIF KIG BP YEBNKIQPKHED CJBIDN; J EF CID EFHI

VTE BP QPKHEDNP FE EGKTEGHDP MEGHDI ME BP KBPFNSNKPKNRG ME POEGHEF KPDKNGROEGIF; EG EB ODTCI

GWUEDI TGI; FEOWG BP 0OEGKNP *GHEDGPKNIGPB ME *GZEFHNOPKNRG MEB !LGKED\ -PJ KBPDPF FIFCEKYPF

ME KRUI PKHWP MNKYI UNKDIIDOPGNFUI EG EB MEFPDDIBBI MEB KLGKED OLFHDNKI; CEDI EB UEKPGNFUI ME

PKKNRG; KIUI HPB; GI FE YP MNBTKNMPMI KIUCBEHPUEGHE\

$G ESEKHI; E[NFHEG MIF CDICTEFHPF EG EB CPCEB; VTE DEBPKNIGPG BP FTCTEFHP KPCPKNMPM ME BP

YEBNKIQPKHED ME FED TG POEGHE KPDKNGROEGI\ 0 CEFPD ME VTE EFHIF MIF UEKPGNFUIF GI OTPDMPG

TGP DEBPKNRG HPG EFHDEKYP EGHDE F_; NGZEFHNOPKNIGEF FE YPG YEKYI STGMPUEGHPMPF FIQDE BPF MIF

NMEPF CBPHEPMPF; J PUQPF YPG KIGMTKNMI P DEFTBHPMIF VTE FN QNEG GI KTEGHPG KIG TG KPDLKHED

HIHPBUEGHE KIGKBTJEGHE; FN PQDEG TG QTEG CPGIDPUP PBDEMEMID ME BP YEBNKIQPKHED CJBIDN J FT

DEBPKNRG KIG EB KLGKED OLFHDNKI\

$B CDNUED UEKPGNFUI VTE FE YP CDICTEFHI NGZIBTKDP TGP CIFNQNBNMPM EG BP KTPB FE OEGEDPG

DPMNKPBEF BNQDEF ME I[_OEGI PB YPQED BP NGSEKKNRG CID YEBNKIQPKHED\ !BPDI EFHL VTE MEFCT`F ME TGHNEUCI CDIBIGOPMI; NGEFCEK_SNKI; ME NGSEKKNRG EF KTPGMI FE KIUNEG^PG P IQFEDZPD MNKYIF

KPUQNIF\ 0 FT ZE^; EFHIF KPUQNIF CDIMTKND_PG TGP MNFHIDFNRG KEBTBPD VTE PTUEGHPD_P BP HPFP ME

UTHPKNRG MEB YT`FCEM KEBTBPD; VTE EG EFHE KPFI FE HDPHP MEB ECNHEBNI OLFHDNKI\ !IG EB HNEUCI; BPF

K`BTBPF EGHDPD_PG EG TG CEDNIMI J EFHPMI ME ZTBGEDPQNBNMPM J PHDISNP UEHPQRBNKPF; EG MRGME FE

IQFEDZPD_PG KPUQNIF UEHPCBLFNKIF; MNFCBLFNKIF J SNGPBUEGHE GEICBLFNKIF; BI VTE ME SIDUP


10/20

OEGEDPBN^PMP HEDUNGPD_P CID KPTFPD KLGKED OLFHDNKI P HIMPF BTKEF\ $FHE CDIKEFI; FE DENHEDP; EF

UTJ BPDOI; J CID HPGHI GI YPJ SIDUP KBPDP ME MNBTKNMPD KIUI HPB BP ZEDPKNMPM MEB UNFUI\ )PUQN`G;

MEQNMI P VTE EF NUCIFNQBE MEHEDUNGPD BP SEKYP I HNEUCI MEFME VTE FE NGNKNR TGP NGSEKKNRG CID

YEBNKIQPKHED CJBIDN; EF NUCIFNQBE KTPGHNSNKPD; P FT ZE^; EB HNEUCI EG VTE EB KLGKED FE YP

MEFPDDIBBPMI\

$B FEOTGMI UEKPGNFUI CIFHTBPMI YP PMVTNDNMI EB GIUQDE ME lDTHP CEDN OEG`HNKPl; J EFHE NGZIBTKDP

TGP YNCIH`HNKP HDPGFSIDUPKNRG MEB SEGIHNCI; J MEFCT`F MEB OEGIHNCI ME BP K`BTBP YT`FCEM; I FEP;

BPF CDICNPF MEB ECNHEBNI EFHIUPKPB; CID UEMNI I MEQNMI P PBHEDPKNIGEF GEOPHNZPF ME BPF EFHDTKHTDPF

CDIHE_GNKPF NGHDP J E[HDPKEBTBPDEF; CEDI EG EFCEKNPB BPF VTE FNDZEG ME UIB`KTBPF ME PMYEFNRG

KEBTBPD\ .P CDICTEFHP UEGKNIGP BP CIFNQNBNMPM VTE CIMD_P E[NFHND ME VTE BP NGSEKKNRG CID

YEBNKIQPKHED NGMT^KP CDIKEFIF NGSBPUPHIDNIF; J EG KIGFEKTEGKNP GNZEBEF EBEZPMIF ME NGHEDBETKNGP

FENF; SPKHID ME GEKDIFNF HTUIDPB PBSP J IHDIF EBEUEGHIF NUCIDHPGHEF ME DEFCTEFHP NGUTGNHPDNP\ .ICBPGHEPMI E[CIGMD_P EGHIGKEF VTE HIMPF `FHPF UIB`KTBPF FEXPBN^PMIDPF I SPKNBNHPMIDPF ME BP

NGSBPUPKNRG; EG EFCEKNPB EB SPKHID ME GEKDIFNF HTUIDPB PBSP; BBEOPD_P EG TG CTGHI P NGHEDSEDND BP

DEBPKNRG ME PMYEFNRG KEBTBPD ME BPF K`BTBPF ECNHEBNPBEF MEB HE]NMI OLFHDNKI; CDIMTKNEGMI EG

KIGFEKTEGKNP NGEFHPQNBNMPM EFHDTKHTDPB P GNZEB YNFHIBRONKI; KIG UNODPKNRG J MNFCEDFNRG ME MNKYPF

K`BTBPF; VTE EFHPD_PG UTHPMPF; J EG EHPCPF GTEZPUEGHE ME CDEMNFCIFNKNRG P KLGKED\ $FHI GI

NUCBNKPD_P EGHIGKEF UIMNSNKPKNIGEF P GNZEB OEGRUNKI FIQDE BP EFHDTKHTDP ME BIF SPKHIDEF

NGUTGIBRONKIF; CEDI F_ ME FT IDOPGN^PKNRG EFCPKNPB J PKICBPMP EG EB IDOPGNFUI\

$G CP_FEF EG MEFPDDIBBI; KRUI 4`[NKI; BP HPFP ME NGSEKKNRG CID YEBNKIQPKHED CJBIDN ZP EG KIGFHPGHE

MEKDEKNUNEGHI; MEQNMI P CIB_HNKPF ME FPBTM VTE YPG FNMI CBPGHEPMPF MEFME YPKE JP PBOTGIF PXIF;

PMEULF ME UE]IDPF EG BP KPCPKNMPM ME FT HDPHPUNEGHI KIG TFI ME PGHNQNRHNKIF EFCEKNPBN^PMIF J

MEULF SLDUPKIF YPG FNMI ME ODPG PJTMP\ 4TKYP NGSIDUPKNRG PDDI]P E[CEKHPHNZPF PHDPKHNZPF FIQDE

BPF UE]IDPF EG EB FNFHEUP ME FPBTM; VTE YPG NMI NUCBEUEGHLGMIFE ME HNEUCI EG HNEUCI; J YP FNMI

IQFEDZPMP JP TGP MNFUNGTKNRG ME EGHDE ZENGHE J HDENGHP J KNGKI CID KNEGHI EG BP NGKNMEGKNP MEB

KLGKED OLFHDNKI\

(E YP IQFEDZPMI VTE EB KLGKED HDPHPMI GI HNEGE TGP EHNIBIO_P KNEG CID KNEGHI MEHEDUNGPMP; CEDI

VTE FN OI^P ME NGHEDEFPGHEF CDICTEFHPF MEFKDNHPF YPKE TG UIUEGHI\ .P NGZEFHNOPKNRG EFHL

PKHTPBUEGHE HDPQP]PGMI EG BP PDMTP HPDEP ME MESNGND PB SNG EB IDNOEG DEPB J KIGKDEHI ME BP CPHIBIO_P

DEBPKNIGPMP KIG BP YEBNKIQPKHED CJBIDN; J FE EFCEDP VTE EG CIKIF PXIF FEP MNBTKNMPMP

KIUCBEHPUEGHE\


11/20

.PF KIGFEKTEGKNPF MEB KLGKED OLFHDNKI SPKNBNHPMI CID YEBNKIQPKHED CJBIDN FIG; EG OEGEDPB; FNUNBPDEF

P BPF MEB KLGKED CDIZIKPMI CID KTPBVTNED IHDI UEMNI\ $F MEKND; BP EZIBTKNRG J E[CEKHPHNZPF MEB

CPKNEGHE; TGP ZE^ MEHEKHPMI EB KLGKED; GI ZPG P MNSEDND ME BPF ME IHDI CPKNEGHE GEICBLFNKI FEZEDI;

J EG KTPGHI PB HDPHPUNEGHI; EB WGNKI PODEOPMI CPDP PVTEB KIG NGSEKKNRG CID YEBNKIQPKHED EF BP

EDDPMNKPKNRG ME BP QPKHEDNP MEB IDOPGNFUI PSEKHPMI\ .PF KIGFEKTEGKNPF VTE ZP P CDEFEGHPD EB

CPKNEGHE KIG KLGKED OLFHDNKI FIG EG FT UPJID_P UTJ FEZEDPF; J ZPG MEFME EB LUQNHI QNIBRONKI

YPFHP EB FIKNPB; BPQIDPB; SPUNBNPD; J MEULF\ (E FPQE VTE EB KLGKED EF TGP ME BPF EGSEDUEMPMEF

KIG CEID CDIGRFHNKI J KIG EZIBTKNRG DLCNMP TGP ZE^ NGNKNPMI\ 3G YEKYI NUCIDHPGHE EG KTPGHI PB

MNPOGRFHNKI ME KLGKED OLFHDNKI EG 4`[NKI EF VTE OEGEDPBUEGHE FE MEHEKHP HPDM_PUEGHE; MEQNMI

PB MEFKIGIKNUNEGHI I NGE[PKHNHTM MEB UEKPGNFUI ME NGSEKKNRG J MEFPDDIBBI ME BP EGSEDUEMPM; J

CID BI HPGHI EB HDPHPUNEGHI CDEKI^ HNEGME P FED JP NUCIFNQBE\ (E DEPBN^P EGHIGKEF TG HDPHPUNEGHI

ULF PODEFNZI; VTE KIGFHP CDNGKNCPBUEGHE ME PKHIF VTNDWDONKIF KIUI BP OPFHDEKHIU_P\ 5E YEKYI;TGP ME BPF KIGFEKTEGKNPF CDNGKNCPBEF MEB KLGKED OLFHDNKI EF BP PHDISNP HIHPB; J CID HPGHI;

MNFSTGKNIGPBNMPM MEB EFHRUPOI; PF_ KIUI FT CEBNODIFP HEGMEGKNP P E[HEGMED FT KIGMNKNRG P IHDIF

RDOPGIF; J EF CID EFI VTE BP OPFHDEKHIU_P CPDKNPB I HIHPB FE ZTEBZE TGP GEKEFNMPM BPF ULF ME BPF

ZEKEF\ $GHDE IHDPF KIGFEKTEGKNPF FE EGKTEGHDPG HPUQN`G ZPDNPF DEBPKNIGPMPF KIG BIF

HDPHPUNEGHIF POIHPMIDEF KIGHDP BP EGSEDUEMPM\ 5EFCT`F ME VTNUNIHEDPCNP I DPMNIHEDPCNP;

HDPHPUNEGHIF GEKEFPDNIF EG BP UPJID_P ME BPF ZEKEF; E[NFHEG CEDNIMIF ME MIBID NGHEGFI; ME

MEQNBNMPM UTFKTBPD; CPBNME^; PCPH_P; MECDEFNRG; EGHDE IHDPF KIFPF\ , FIG HIMIF EFHIF EFHPMIF VTE

HNEGMEG P UPGHEGEDFE P BI BPDOI ME BP ZNMP; CTEFHI VTE GIDUPBUEGHE EF NGKTDPQBE EB KLGKED

OLFHDNKI\ )IMI EFHI KIGBBEZP CDIQBEUPF CPDP BBEZPD TGP ZNMP GIDUPB; YPQNEGMI C`DMNMP ME

ZNHPBNMPM; MEFKTNMI MEB HDPQP]I J ME BPF DEBPKNIGEF SPUNBNPDEF; PB CTGHI EG VTE FE UTEFHDP PCPH_P

OEGEDPBN^PMP J TG EFHPMI ME LGNUI UTJ PSEKHPMI\ 9NGPBUEGHE; FE YP IQFEDZPMI TGP BEZE HPFP ME

FTNKNMNI EG CEDFIGPF VTE FTSDEG ME KLGKED\ 5EQNMI P BP OPFHDEKHIU_P J P CDIKEFIF VTNDWDONKIF

DEBPKNIGPMIF; BP CEDFIGP VTEMP DEFHDNGONMP MEB KIGFTUI ME ZPDNIF HNCIF ME PBNUEGHIF; CEDI

EFCEKNPBUEGHE BIF FRBNMIF; CTEFHI VTE IKTDDE TGP MNFSTGKNRG; HPUQN`G CPDKNPB I HIHPB; ME BP

SNFNIBIO_P MNOEFHNZP GIDUPB\

e\eb !IUIDQNBNMPM

-PJ TGP FEDNE ME EGSEDUEMPMEF VTE YPG FNMI NMEGHNSNKPMPF EG KNEDHI ODPMI KIG EB KLGKED OLFHDNKI

MEDNZPMI ME NGSEKKNRG CID YEBNKIQPKHED CJBIDN\ (IG; FNG EUQPDOI J GIDUPBUEGHE; CDIKEFIF


12/20

FEKTEGKNPBEF VTE SNGPBUEGHE MEDNZPG P BP KIGMNKNRG KPDKNGROEGP\ )PUQN`G FIG BIF FNOTNEGHEF

CPMEKNUNEGHIF KIUCBNKPKNIGEF KIUTGEF CID TGP NGSEKKNRG GI KIGHDIBPMP CID YEBNKIQPKHED\ 5E BPF

UTKYPF EGSEDUEMPMEF DEBPKNIGPMPF FIBI FE CPFPG P MEFKDNQND ULF P SIGMI HDEF ME EBBPF; BPF

KTPBEF EFHLG _GHNUPUEGHE DEBPKNIGPMPF KIG EB KLGKED OLFHDNKI; HPGHI PF_ VTE FT FIBP CDEFEGKNP

UTKYPF ZEKEF EF NGMNKPMID ME VTE EF NGUNGEGHE TGP GEICBPFNP FN GI FE HDPHP MEQNMPUEGHE BP

FNGHIUPHIBIO_P\ 0BOTGPF ME BPF EGSEDUEMPMEF VTE HNEGEG HIHPB DEBPKNRG KIG EB KLGKED OLFHDNKI J

BP QPKHEDNP FIG BPF FNOTNEGHEF2

S-/,42 D=D3./2T EF TGP BEFNRG EG BP UEUQDPGP UTKIFP MEB EFHRUPOI; VTE HNEGE SIDUP ME KDLHED;

J VTE EF UTJ DEGTEGHE P BP KNKPHDN^PKNRG\ .P NGKNMEGKNP EG YIUQDEF J UT]EDEF EF FNUNBPD\ .P KPTFP

ME BP TBKEDPKNRG EF EB MEFEVTNBNQDNI EGHDE SPKHIDEF PODEFNZIF J CDIHEKHIDEF CDEFEGHEF EG BP UTKIFP

OLFHDNKP; P SPZID ME BIF MPXNGIF; J EF PY_ MIGME FE EGKTEGHDP BP YEBNKIQPKHED CJBIDN KIUI TGI MEBIF POEGHEF ULF PODEFNZIF\ (E YP EGKIGHDPMI VTE CDLKHNKPUEGHE EB KNEG CID KNEGHI ME BIF

CPKNEGHEF KIG KLGKED DEBPKNIGPMI P YEBNKIQPKHED YPG HEGNMI PGHEF VTE CPFPD CID TGP EHPCP ME

TBKEDPKNRG OLFHDNKP UIMEDPMP P FEZEDP\

:2;34.3.; /4F9./2T CDNUEDPUEGHE; FE MEQE EGHEGMED VTE BP OPFHDNHNF EF BP NGSBPUPKNRG ME BP

UTKIFP OLFHDNKP; KIG EGDI]EKNUNEGHI PODEOPMI J KIG CDEFEGKNP ME UPGKYP PWG ULF DI]N^PF VTE

DECDEFEGHPG HPGHP NDDNHPKNRG KRUI YEUIDDPONPF UTKIFPF\ 5ECEGMNEGMI MEB MPXI J ME BP

OEGEDPBN^PKNRG ME BP FNHTPKNRG; FE CTEME KBPFNSNKPD EG MNZEDFIF ODPMIF\ $B YEBNKCQPKHED CJBIDN; ]TGHI

KIG SPKHIDEF PTHINGUTGEF VTE FE KDEE VTE HNEGEG CPDHNKNCPKNRG KIGHDP EB UNFUI; FIG ME BIF

SPKHIDEF ULF KIUTGEF VTE MEFEGKPMEGPG BP OPFHDNHNF\ 1DICNPUEGHE; BP OPFHDNHNF KDRGNKP FE DESNEDE

P KTPGMI EFHP JP FE YP UPGHEGNMI CID TG BPDOI CEDNIMI ME HNEUCI; J VTE YP NMI ODPMTPBUEGHE

PTUEGHPGMI EG FEZEDNMPM\ 5EFME BIF MIF UEFEF ME CEDFNFHEGKNP; FE CTEME KIGFNMEDPD BP

E[NFHEGKNP ME OPFHDNHNF KDRGNKP\ .P SIDUP VTE KIDDEFCIGME P BP NGSEKKNRG CID YEBNKIQPKHED EF BP

OPFHDNHNF KDRGNKP HNCI /; BP KTPB BBEOP P PSEKHPD PB PGHDI CNBRDNKI J P HIMP BP UTKIFP MEB RDOPGI;

YPFHP BBEOPD P NGZPMND HPGHI EFRSPOI KIUI MTIMEGI\

&;FU2@0 C, V244,3T EF DESEDNMI KIUI TG KPUQNI GI GIDUPB ME BPF K`BTBPF VTE KIGSIDUPG EB

WBHNUI FEOUEGHI EFISLONKI; J VTE GIDUPBUEGHE EF TGP UEHPCBPFNP; DEFTBHPMI ME BEFNIGEF ME BP

UTKIFP OLFHDNKP KIUQNGPMP KIG DESBT]I MEQNMI P TGP E[CIFNKNRG CDIBIGOPMP PB LKNMI KBIDY_MDNKI\


13/20

(E CDEFEGHP EG EB MNE^ CID KNEGHI ME CPKNEGHEF KIG DESBT]I OPFHDIEFISLONKI; J EG PBDEMEMID MEB

HDENGHP CID KNEGHI ME PVTEBBIF NGSEKHPMIF CID YEBNKIQPKHED CJBIDN; FNEGMI MNPOGIFHNKPMI EG ULF MEB

GIZEGHP J MIF CID KNEGHI ME CPKNEGHEF KIG KLGKED OLFHDNKI DEBPKNIGPMI KIG -EBNKIQPKHED\ !IUI

HPB; EF TG HDPFHIDGI CDEUPBNOGI; I FEP; TG CDEKTDFID ME MNKYI KLGKED; PMEULF ME KLGKED

EFISLONKI\

#I FE MEFKPDHP VTE CIMD_P FED HPUQN`G EB EFRSPOI ME /PDDEH TGP KIGFEKTEGKNP MEB KLGKED EG

KTEFHNRG\ 1ID WBHNUI; E[NFHEG PBOTGPF IHDPF EGSEDUEMPMEF VTE EFHLG DEBPKNIGPMPF P BP NGSEKKNRG;

CEDI VTE CDICNPUEGHE CIMD_PG GI EFHPD BNOPMPF PB KLGKED OLFHDNKI\ $B BNGSIUP ME HE]NMI BNGSINME

PFIKNPMI P UTKIFP EF IHDI HNCI ME KLGKED CDICNKNPMI CID -EBNKIQPKHED; EB KTPB FE YP IQFEDZPMI

EG UEGID CDICIDKNRG; CEDI KIG PODEFNZNMPM FNUNBPD PB KLGKED OLFHDNKI\ .P MNFCECFNP; VTE FE DESNEDE

P TGP FEGFPKNRG NGKRUIMP ME MNFHEGFNRG OLFHDNKP; FE IQFEDZP KIUWGUEGHE EG NGSEKHPMIF; CEDI

FTEBE FED CPFP]EDP J CIKI PODEFNZP\ +HDIF HNCIF ME OPFHDNHNF UEGIF FEZEDP HPUQN`G FE IQFEDZPGEG EHPCPF NGNKNPBEF ME NGSEKKNRG; CEDI GIDUPBUEGHE GI BBEOPG P FED CDIQBEUPF UPJIDEF\ $G

PBOTGIF CPKNEGHEF; FE YP IQFEDZPMI KNEDHP MEOEGEDPKNRG CDIODEFNZP ME BP UTKIFP VTE FE

PKIUCPXP ME C`DMNMP ME STGKNIGEF EG^NULHNKPF; CID BI VTE FE CNEGFP VTE EFHI CIMD_P FED KPTFP

ME NGHIBEDPGKNP ME BP CEDFIGP YPKNP MNFHNGHIF PBNUEGHIF\

e\mb 4EMNMPF ME 1DEZEGKNRG J (PBTM 1WQBNKP

.P NGSEKKNRG CID YEBNKIQPKHED CJBIDN EF TG CDIKEFI UTJ KIUWG; J ULF BI EF CID EB YEKYI ME VTE

CDLKHNKPUEGHE BP FIKNEMPM UE[NKPGP KIGZNZE KIG EFHE UNKDIIDOPGNFUI P HIMP YIDP J EG HIMI

BTOPD\ .IF CDIQBEUPF KIUNEG^PG KTPGMI CID PBOWG UIHNZI ME BIF PGHEF E[CTEFHIF; BP QPKHEDNP

KIUNEG^P P HEGED UPJID CDEFEGKNP J UIDQNBNMPM FIQDE EB IDOPGNFUI PSEKHPMI\ 0BDEMEMID MEB

IKYEGHP CID KNEGHI ME BP CIQBPKNRG UE[NKPGP HNEGE CDEFEGKNP ME YEBNKIQPKHED EG FT HTQI MNOEFHNZI;

CEDI FIBI TGP CEVTEXP KPGHNMPM ME EFHP MEFPDDIBBP CPHIBIO_PF DEBPKNIGPMPF PB UNFUI\

5E HIMPF SIDUPF; FE YPG QTFKPMI; ULF EG BIF WBHNUIF PXIF; UEMNMPF CPDP MNFUNGTND EB GNZEB ME

NGSEKKNRG I BP CDEFEGKNP ME BP QPKHEDNP EG EB UEMNI PUQNEGHE UE[NKPGI; EFHI CID EB YEKYI UNFUI

ME VTE FT FIBP CDEFEGKNP GI MEHEDUNGP; CEDI YPKE FIFCEKYPD ME TGP CIFNQBE NGKNMEGKNP ME

EGSEDUEMPM\ .PF UEMNMPF ME CDEZEGKNRG VTE FE ICHPG CID BBEZPD P KPQI FIG CDNGKNCPBUEGHE ME

HNCI YNON`GNKI J MNEH`HNKI\ $FHPF NGKBTJEG2

EB BPZPDFE BPF UPGIF PGHEF ME KIUED


14/20

CDECPDPD BIF PBNUEGHIF KIG QTEGP BNUCNE^P

CDEFEGHPD HTQED_PF ME POTP; J POTP CIHPQBE EG EFHPMIF PMEKTPMIF J BNQDEF ME KIGHPUNGPKNRG

GI HEGED UPFKIHPF UEDIMEPGMI MEGHDI ME BP KPFP HIMI EB HNEUCI

0 HIMI EFHI FE BE BBPUP CDEZEGKNRG CDNUPDNP; JP VTE EF KIG EB IQ]EHNZI ME CDEZEGND EG CDNUEDP

NGFHPGKNP BP EGHDPMP ME BP QPKHEDNP PB IDOPGNFUI\

)PUQN`G FE KIGFNMEDPG UEMNMPF CDEZEGHNZPF ME FEOTGMI IDMEG; BPF KTPBEF GI CDICNPUEGHE

CDEZNEGEG EB KLGKED OLFHDNKI; CEDI NGMNKPG TG MNPOGRFHNKI CDEKI^ CPDP VTE EB HDPHPUNEGHI FEP BI

ULF CDIZEKYIFI CIFNQBE\ (N STEDP EB KPFI ME VTE EB KLGKED FE MNPOGIFHNKPDP HPDM_PUEGHE; EB

HDPHPUNEGHI P BI UTKYI PBPDOPD_P TG CIKI BP EFCEDPG^P ME ZNMP MEB FT]EHI; CEDI UTJ MNS_KNBUEGHE;

FNGI VTE NUCIFNQBE; BIODPD_P TG ESEKHI HEDPC`THNKI ME KTDPKNRG\ 1ID HPB UIHNZI; FE CDICIGE P BP

CIQBPKNRG CDNUEDPUEGHE BP UE]ID_P ME FTF YLQNHIF KIHNMNPGIF; ME FT YNONEGE; CTEF PB EGKIGHDPDFE

BP QPKHEDNP EG HIMPF CPDHEF; UTJ SLKNBUEGHE EF PMVTNDNMP CID MEFKTNMI\

)IUPGMI EFHI EG KTEGHP; BI VTE FE MEFKDNQE GI EF FNGI TG IQ]EHNZI P BPDOI CBP^I; ME

KIGKNEGHN^PKNRG P BPF CEDFIGPF J HPUQN`G ME EMTKPKNRG; CPDP VTE BPF STHTDPF OEGEDPKNIGEF HIUEG

EG KTEGHP J PCDEGMPG BI KIGKEDGNEGHE P BP CDEZEGKNRG ME BP NGSEKKNRG; GI EG FEGHNMI EFHDNKHI; CEDI

F_ KIUI KIFHTUQDE\ 5E UPGEDP VTE BIF YLQNHIF VTE ZPJPG MEFPDDIBBPGMI FEPG BI FTSNKNEGHEUEGHE

PMEKTPMIF CPDP VTE GI CDICNKNEG TGP NGSEKKNRG QPKHEDNPGP VTE P BPF CEDFIGPF BEF CIMD_P DEFTBHPD

EG TGP ODPZE EGSEDUEMPM\


15/20


16/20

e\nb )EFHNUIGNIF ME 1PKNEGHEF UE[NKPGIF

)$()*4+#*+ a

-IBP ; QTEGPF HPDMEF UN GIUQDE EF 4RGNKP /EKEDDNB ; HEGOI ne PXIF J FIJ IDNONGPDNP MEB EFHPMI

ME 1TEQBP ; YPKE f UEFEF UE MEHEKHPDIG KLGKED OLFHDNKI \)IMI KIUEG^R KTPGMI KIGHNGTPUEGHE

HEG_P MIBID EFHIUPKPB J GPTFEPF ; PB CDNGKNCNI KDE_ VTE PBOI VTE YPQ_P KIUNMI UE YN^I MPXI ;

CEDI BIF UPBEFHPDEF KIGHNGTPDIG J UE MEKNM_ CID KIGFTBHPD P UN U`MNKI ; PB BBEOPD KIG B UE UPGMR

P YPKEDUE UTKYIF PGLBNFNF J UE MN]I VTE CDIQPQBEUEGHE JI HEG_P KLGKED OLFHDNKI P BI KTPB UE

VTEM` FTUPUEGHE FIDCDEGMNMP J MEKNM_ ND KIG TG EFCEKNPBNFHP CPDP VTE UE FPKPDP ME BP MTMP ;

TGP ZE^ KIGFTBHPGMI KIG EB WBHNUI MIKHID ; UE PSNDUR VTE CPMEK_P ME KLGKED OLFHDNKI J VTE

MEQ_PG CDIODPUPD BP ICEDPKNRG BI ULF DLCNMI CIFNQBE ; HPUQN`G UE E[CBNKR VTE BP KPTFP MEB

KLGKED VTE CPMEK_P EDP MEQNMI P VTE PMVTND_ TGP QPKHEDNP KIGIKNMP KIUI -EBNKIQPKHED 1JBIDN JP

VTE KIGFTU_ POTP KIGHPUNGPMP ; FHP MNKYP QPKHEDNP YPQ_P HDPFCPFPMI TGP KPCP ME UN EFHRUPOI

VTE FE BBPUP UTKIFP J VTE P CPDHND ME EBBP ; CDIZIKR TGP WBKEDP OLFHDNKP BI VTE MEFEGKPMEGR BP

EGSEDUEMPM VTE UE EFHPQP PHPKPGMI CIKI P CIKI \ 0B CDNGKNCNI UE FEGH_P FTUPUEGHE

KIGFHEDGPMP CID BI VTE UE EFHPQP CPFPGMI; CEDI KIG EB PCIJI ME UN SPUNBNP BIOD` FPBND PMEBPGHE

J BP ICEDPKNRG STE TG [NHI\ , MEFME EFP IKPFNRG KTNMI FTUPUEGHE BI VTE KIGFTUI KIG UN SPUNBNP\

)$()*4+#*+ e

-IBP ; UTJ QTEGPF HPDMEF ]RZEGEF ; FIJ EB 5IKHID 4PTDNKNI 8NBBEOPF OPFHDIEGHEDRBIOI MEB EFHPMI

ME 1TEQBP ; KIG QPFE P BP CDIQBEULHNKP ME FPBTM VTE EFHPUIF ZNZNEGMI YIJ EG M_P ME PKTEDMI

KIG EB KLGKED OLFHDNKI ; BEF CTEMI YPKED UEGKNRG VTE EF TGP ME BPF EGSEDUEMPMEF ULF HDPHPMPF

EG `FHP WBHNUP M`KPMP ; MEQNMI P BP UPBP PBNUEGHPKNRG CID CPDHE ME BP CIQBPKNRG \ )PUQN`G CTEMI


17/20

MEKNDBEF VTE EB GI KTUCBND KIG BPF UEMNMPF ME YNONEGE GEKEFPDNPF CPDP CDECPDPD GTEFHDIF

PBNUEGHIF NGKDEUEGHP MNKYP EGSEDUEMPM ; PTUEGHPGMI EB DEBEZPGHE MEFPDDIBBI ME BP QPKHEDNP

-EBNKIQPKHED 1JBIDN ; BP KTPB FE KIGFNMEDP CDNGKNCPB SPKHID KIUI MEFPDDIBBI MEB KLGKED OLFHDNKI\

0TGPGMI P HIMI EFHI BE CIMEUIF PODEOPD BPF WBKEDPF C`CHNKPF; BP OPFHDNHNF J TG FNG SNG ME

EGSEDUEMPMEF VTE FNG MTMP PBOTGP FE YPG KIGZEDHNMI EG BIF CDNGKNCPBEF PBNPMIF ME UIDHPBNMPM J

UIDQNBNMPM CPDP GTEFHDI CP_F\


18/20

%?"%PMG$N"!IUI KIGKBTFNRG; MEFCT`F ME YPQED FNMI E[CTEFHPF HPGHPF KPDPKHED_FHNKPF QNIBRONKPF ME BP

QPKHEDNP -EBNKIQPKHED 1JBIDN; PF_ KIUI FT DEBPKNRG KIG EB KLGKED OLFHDNKI; PMEULF ME BP EZIBTKNRG;

KIUIDQNBNMPM; KPTFPF J KIGFEKTEGKNPF MEB UNFUI; FE CTEME MEKND VTE KNEDHPUEGHE BP NGSEKKNRG

CID EFHP QPKHEDNP EF TG ODPG CDIQBEUP ME FPBTM CWQBNKP\ (IG CIKPF; EG CDICIDKNRG; BPF CEDFIGPF

VTE MEFPDDIBBPG CPHIBIO_PF CID MNKYP NGSEKKNRG; CEDI FNG MTMP BI VTE E[CEDNUEGHPG GI EF CPDP

GPMP PODPMPQBE; FNGI HIMI BI KIGHDPDNI\ (E YP EGHEGMNMI PYIDP BP NUCIDHPGKNP ME KIGIKED EFHE

POEGHE VTE FE EGKTEGHDP MNFHDNQTNMI EG HIMPF CPDHEF; TGI VTE EF NUCIFNQBE PNFBPD; J CID HPGHI; EF

EB MEQED MEB FED YTUPGI; CEDI EG KIGKDEHI J EG EFHP IKPFNRG; ME BP FIKNEMPM UE[NKPGP; EB HIUPD

UEMNMPF ME PKKNRG; UEMNMPF CDEZEGHNZPF; KIG EB SNG ME VTE BP QPKHEDNP; PB SNG J PB KPQI FNOP FNEGMI;

CEDI GI FE HIDGE PODEFNZP J BIODE CED]TMNKPD PB IDOPGNFUI\ !IUI FE UEGKNIGR EG PBOTGP IKPFNRG;BP QPKHEDNP JP EFHL; CEDI BI VTE VTEMP PYIDP EF EMTKPD P BPF STHTDPF OEGEDPKNIGEF CPDP VTE ZPJPG

UIMTBPGMI J KPUQNPGMI FTF KIFHTUQDEF ME YNONEGE J FTF UEMNMPF ME FPBTM; CPDP VTE FE FNOP

DEMTKNEGMI BI ULF VTE FE CTEMP BP NGSEKKNRG CID -EBNKIQPKHED CJBIDN J EB KLGKED OLFHDNKI; J HIMPF

BPF MEULF EGSEDUEMPMEF VTE YPG FNMI HDPHPMPF\ (E EFCEDP VTE EB BEKHID PYIDP EFH` UE]ID

NGSIDUPMI FIQDE BPF KNDKTGFHPGKNPF J KIGFEKTEGKNPF VTE DIMEPG PB -EBNKIQPKHED; J VTE BE FNDZP

HIMI EFHI ME CPTHP CPDP YPKED TG KPUQNI; J PJTMPD PB UTGMI; CPDP CDEZEGND\


19/20

L&Q&L&"%$OGd 4IHHP %PU_DE^; 'PFCPD 0BQEDHI; 0BUP^LG 3DQNGP; 9DPGKNFKI $MTPDMI\ (ECHNEUQDEb+KHTQDE

ekaf\ 0DH_KTBI +DNONGPB2 $B KLGKED OLFHDNKI EG TGP NGFHNHTKNRG ME HEDKED GNZEB; KIDDEBPKNRG

EGMIFKRCNKP; CID HIUIODPS_P KIUCTHPDN^PMP E YNFHICPHIBIO_P MEB KLGKED OLFHDNKI EG EB YIFCNHPB

KEGHDPB UNBNHPD\ *UQNIUEM; f; aobef\

d (LGKYE^ /PDDNPOP\pp i0CDNBbpTGE ekaoj\ 0DH_KTBI +DNONGPB2 )EGMEGKNPF ME UIDHPBNMPM J PXIF

CIHEGKNPBEF ME ZNMP CEDMNMIF CID KLGKED OLFHDNKI EG 4`[NKI; ekkkbekae \*4/*+4$5; 8IB\qA\

CPO\ Abef\

d 4PDHNGE^ !PDDNBBI 5#; 0HDNFKI 4IDPBEF p\; -EDGPGME^ 1PGMI %IOEBNI ; %EJEF #PZPDDEHE (\ ;

/EHPGKITD %EJEF .NGPDEF; !DT^ MEB !PDUEG *\ ; i 4`[NKI ekanj \ 5NZEDFNMPM ME BIF OEGIHNCIF

8PK0 J !PO0 ME -EBNKIQPKHED 1JBIDN J EFCDEFNRG ME NGHEDSEDRG OPUUP EG CPKNEGHEF KIG OPFHDNHNFKDRGNKP J KLGKED OLFHDNKI\ *4/*+4$5\ 8IB\qA\ CPO\ eekbee>\

d %PWB 3\ -EDGLGME^ %PUNDE^ \ 4\ EG ! iaj \ .N^QEHY .RCE^ !PDDNBBI 5 EG (1 iaj\i A ME EGEDI ME

ekanj \ 5NEHP J !LGKED 'LFHDNKI EG 4`[NKI J EG EB 4TGMI \ 4EMNKBPHNGP\fo\ CPO\ eabef\

d %PWB %IUEDI !PQEBBI \ 4NKDIQNIBIO_P J 1PDPFNHIBIO_P -TUPGP h 4NKDIQNIBIOJ PGM -TUPG

1PDPFNHIBIOJ \ /PFEF EHNIBRONKPF ME BPF EGSEDUEMPMEF NGSEKKNIFPF J CPDPFNHPDNPF \ m r $MNKNRG \

$5*)+%*0. 21PGPUEDNKPGP\

d 3GNZEDFNMPM 4PJID ME (PG (NURG \ 9PKTBHPM ME 4EMNKNGP \ )_HTBI 2 -EBNKIQPKHED 1JBIDN J

BEFNIGEF NGSBPUPHIDNPF 'PFHDIMITMEGPBEF \ !IDDEBPKNRG $GMIFKRCNKP J 0GPHIUICPHIBRONKP \

aAAa\ CPO\am\

d 5IKHID 4PGTEB 0KTXP )IZPD ; 5IKHID $MOPD %IULG /PFFPTDE\ekam \ +GKIBIO_P aaa\ !LGKED

ME EFHRUPOI\ 'TNPF 5NPOGRFHNKPF

ekam\YHHC2hhsss\YOU\FPBTM\OIQ\U[hMEFKPDOPFhCMShPDEPtUEMNKPhIGKIhOTNPFhKPGKEDt$FHIUPOI\C

MS

d 5IKHID 9EDGPGMI )IDDEF 8PBPME^; 0BQEDHI 'PDKNP 4EGEGME^ OPFHDIEGHEDRBIOI;0BE]PGMDP

?PDPHE +FIDGI -NFHICPHRBIOP\ ekk>\-EBNKIQPKHED 1JBIDN \ -IFCNHPB ME BP /EGESNKNEGKNP$FCPXIBP\YHHC2hhsss\SPKUEM\TGPU\U[hFUFhFEPUeuahekk>hEGEtkatCIHEGKNP\YHUB\

d 0FIKNPKNRG 4E[NKPGP ME 'PFHDIEGHEDIBIO_P \ ]TBNIbFECHNEUQDE ekam\*GSEKKNRG CID -EBNKIQPKHED

1JBIDN J FT PFIKNPKNRG KIG EB KIGFTUI ME 0BKIYIB \ 8IBq>\ #TU\ m \


20/20

YHHC2hhsss\DEZNFHPOPFHDIEGHEDIBIONPUE[NKI\IDOhEFhNGSEKKNRGbCIDbYEBNKIQPKHEDbCJBIDNb

FThPDHNKTBIh(kmqfkAkoamkkkfooh

d 5IK\9EBNCE 1NXRB pNUEGE^ ;1DIS\ 4NOTEB 1PGNPOTP $FH`ZE^\aAA>\ !LGKED 'LFHDNKI; 9PKHIDEF ME

%NEFOI\*GFHNHTHI ME

'PFHDIEGHEDIBIO_P\YHHC2hhsss\QZF\FBM\KThDEZNFHPFhIGKhZIBantmtA>hIGKkomA>\YHUBvNSDPUEwHDTEx

sNMHYw>kgxYENOYHw>kg

d 1DISEFID $U`DNHI\*GZEFHNOPMID 3GNZEDFNMPM 1EDTPGP !PJEHPGI -EDEMNP\]TBb

FEC\ekk>\-EBNKIQPKHED 1JBIDN J !LGKED

'LFHDNKI\YHHC2hhsss\FKNEBI\IDO\CEhFKNEBI;CYCvFKNCHwFKNtPDHHE[HxCNMw(akeebfaeAekk>kkkmkkkk>

d *GFHNHTHI #PKNIGPB MEB !LGKED\ ekam\-EBNKIQPKHED 1JBIDN J EB

KLGKED\YHHC2hhsss\KPGKED\OIZhEFCPGIBhKPGKEDhKPTFPFbCDEZEGKNIGhDNEFOIhOEDUEGEFb

NGSEKKNIFIFhYI]PbNGSIDUPHNZPbYbCJBIDN

Documents

Cáncer Gástrico y Helicobacter Pylori: Un Problema de Salud Pública