30 jun. 2010

Pharmalink AB Closes Deal With Grifols SA for the Acquisition of the Xepol(R) Programme for the Treatment of Post-Polio Syndrome

Pharmalink AB Closes Deal With Grifols SA for the Acquisition of the Xepol(R) Programme for the Treatment of Post-Polio Syndrome

Posted on: Wednesday, 30 June 2010, 03:51 CDT

STOCKHOLMJune 30, 2010 /PRNewswire/ --

- Agreement Marks Milestone in Pharmalink's Corporate Development

Pharmalink AB, today announced that it has closed its agreement with Grifols SA for the acquisition of Pharmalink's Xepol(R) programme for the treatment of post-polio syndrome (PPS). The parties had previously announced reaching an agreement whereby Grifols would acquire all know-how and global intellectual property rights related to the use of human immunoglobulin for the treatment of (PPS) - the concept at the heart of the Xepol programme.
The agreement covers acquisition of one of Pharmalink's wholly owned subsidiaries and includes inter alia US, EU and Japanpatents for the treatment of PPS with immunoglobulins, a US Orphan Drug Designation (ODD) for the use of immunoglobulin for the treatment of PPS and documentation of a number of clinical studies carried out in the recent years.
Johan Haggblad, Managing director of Pharmalink AB said: "This agreement marks a significant milestone in Pharmalink's corporate development. In developing a concept originally devised by academic researchers at the Karolinska Institute and seeing it through to being acquired by a world class company we have demonstrated the considerable value creation made possible by the Pharmalink model. We are very happy to see Grifols, our long standing partner, acquire and develop the PPS indication and to have played a part in bringing forward a treatment for this underserved condition."
Grifols will develop the PPS product opportunity using the acquired assets. Pharmalink will assist in technology transfer and provide contact with its network of physicians and patient organizations. The purchase price is undisclosed but divided into an up-front payment and commercial milestone payments.
The PPS product opportunity is an important means to provide a treatment to a patient group largely suffering without effective medication and to expand sales of immunoglobulin in new patient segments.
About PPS

Several decades after suffering acute polio infection survivors commonly develop PPS characterized by new or increased muscle weakness, fatigue, and pain. Ongoing denervation is the most often suggested for increased muscle weakness associated with polio infection.
Patients with PPS have increased expression of mRNA for proinflammatory cytokines in cerebrospinal fluid which suggests an inflammatory process in the central nervous system. Some patients with asymmetrical weakness have increased wear and tear on joints and muscles, including breathing muscles.
While rarely fatal, the neurological and muscular symptoms of PPS are lifelong and debilitating.
The most recent polio epidemic culminated in the Western countries around 1950. As most infections occur in children, there is nowadays a large pool of polio survivors with varying degrees of functional decline. US National Institute of Neurological Disorders and Stroke (NINDS) gives a prevalence interval for PPS of 25 to 50% (in primary polio infection survivors), WHO estimates a 40 % prevalence; assuming a prevalence of 30%, only in major Western countries there would be around 300,000 PPS patients.

Currently there is no pharmacological treatment for PPS. Several therapeutic agents have failed in achieving positive outcomes. Treatment practices are based on physiotherapy, non-fatiguing exercise and the use of assistive devices. The promising results with immunoglobulin may help address the unmet medical need of some PPS patients. In several clinical trials lead by a team of physicians at Karolinska Institutet (Sweden) and sponsored by Pharmalink AB, immunoglobulin has shown significant and clinically meaningful results in endpoints such as pain, walking ability and quality of life (SF-36 scores) by down-regulating the inflammatory process in the nervous system of PPS patients.
About Pharmalink
Pharmalink is a Swedish specialty pharma company developing high value products for niche indications. Pharmalink draws on its extensive experience of pharmaceutical product development and the excellence of medical science in Sweden to identify and progress products that address significant unmet medical needs. Pharmalink has introduced more than 15 pharmaceutical products to the market. Using a repurposing and reformulation strategy, Pharmalink minimizes the risk of product development. The Company's strategy is to develop drugs to clinical proof-of-concept and then to out-license or divest to a commercial partner. Pharmalink currently has two clinical phase development projects, Nefecon(R) and BusulipoTM, mature for out-licensing to a commercial partner and is actively in-licensing promising new projects to add to its pipeline. Visit http://www.pharmalink.se for further information.

About Grifols
Grifols is a Spanish holding company specialized in the pharmaceutical-hospital sector and is present in more than 90 countries. Since 2006, the company has been listed on the Spanish Stock Exchange ("Mercado Continuo") and is part of the Ibex-35. Currently it is the first company in the European sector in plasma derivatives and the fourth in production worldwide. In upcoming years, the company will strengthen its leadership in the industry as a vertically integrated company, thanks to recent investments. In terms of raw materials, Grifols has ensured its plasma supply with 80 plasmapheresis centers in the United States and in terms of fractionation, its plants in Barcelona (Spain) and Los Angeles (United States) will allow the company to respond to the growing market demand. Nevertheless, the company is preparing for sustained growth in the following 8-10 years and has launched an ambitious investment plan.

For further information, please contact: Pharmalink AB: Johan Haggblad, Managing Director, +46(0)70-668-0644 Email: johan.haggblad@pharmalink.se http://www.pharmalink.se Citigate Dewe Rogerson: Chris Gardner/Nina Enegren, +44-207-638-9571 Grifols SA: Raquel Lumbreras Lanchas/Borja Gomez Vazquez Tel : +34-91-311-92-89/+34-91-311-92-90 Mobile: +34-659-57-21-85 Email: raquel_lumbreras@duomocomunicacion.com borja_gomez@duomocomunicacion.com
SOURCE Pharmalink AB


Source: PR Newswire

28 jun. 2010

APPROVAL OF THE EXISTENCE OF THE POST POLIO SYNDROME IN MEXICO

APPROVAL OF THE EXISTENCE OF THE POST POLIO SYNDROME IN MEXICO


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THE 2ND NATIONAL SYMPOSIUM OF POST POLIO SYNDROME ( PPS )
APPROVAL OF THE EXISTENCE OF THE POST POLIO SYNDROME IN MEXICO

Objective: To raise awareness among medical, paramedical , Therapists signs and symptoms to establish 
a diagnosis and Post Polio Syndrome difference . (SPP ) and provide " quality of life for patients".
Target : physicians. About 350-500 are expected of doctors.Free admission

Headquarters: Auditorium XXI Century Academy of Medicine. Avenida Cuauhtémoc No. 330 ,  of
 the Congress Unit of the "Medical Center Siglo XXI.

Date : July 28 , at 8:00 pm.

What is Post Polio?
Post Polio Syndrome ( PPS ) is a condition that affects polio survivors 15 to 30 years later the recovery of an 
initial acute attack of poliomyelitis virus . The SPP is mainly characterized by new muscle weakness had been
 affected by polio infection and in muscles that seemingly were not affected. Symptoms include slowly progressive
 neuromuscular weakness , fatigue ( both generalized and muscular ) and progressive muscular atrophy.
Due to working with Mexico and it's Disabiltiy Organization CONADIS as well as the Secretary of Health this very 
important and large Symposium is late in getting out to the PPS organizations anddoctors. Please help us spread
 the word! If you know someone else that would like to have this information please forward it! 
Thank your for you help, this is so important to the world of PPS.








Liliana Marasco Garrido
Founder President
Post Polio Survivor
Asociación Post Polio Litaff, A.C_APPLAC
TEL /Fax 55742926



Polio: Parents Get Gifts for Allowing Their Children Immunised


From Segun Awofadeji in Bauchi, 06.28.2010
Bauchi
For allowing their children under five years to be immunised against poliomyelitis and other child killer diseases, parents in Alkaleri Local Government council of Bauchi State got gift items, including detergents, soaps and other household items.
The items which are called ‘pluses’ were distributed as incentives during the implementation of immunisation plus days as well as the on-going 2010 Maternal and New Born Child Health Week/June Immunisation plus Days as monitored in Alkaleri West and East last weekend.
House to house and fixed vaccinators as well as their supervisors went round with detergents as well as soaps which they gave to parents who complied with the exercise.
The Disease Surveillance and Notification Officer  (DSNO) of the council, Likita Abubakar, who conducted our correspondent round, said the gesture has bolstered compliance, adding that "before non compliance was high especially in Alkaleri town but with such measures and the intervention of the Emir of Dass,  Usman Bilyaminu Othman, who is the chairman of the state mobilisation committee, compliance is now 100%.’’

Our correspondent observed that Oral Polio Vaccines, Measles, DPT, TT, Hepatitis B and Yellow Fever vaccines were being administered apart from other medicines which included de-worming tablets and supplements, to the children while officials of the National Population Commission accompanied the vaccinators to issue birth certificates to the children who were not registered before.

26 jun. 2010

Post Polio Syndrome % Symtoms, Cause , Diagnosis, Prognosis

Post-polio syndrome can affect polio survivors many years after recovering from an initial acute attack of the poliovirus. This syndrome is characterized by new muscle pain, worsening of existing weakness, and new weakness or paralysis. The cause is unknown, and there is currently no cure. Treatment is focused on relieving the symptoms. Researchers estimate that this syndrome affects 25 to 50 percent of polio survivors in the United States.
                 Post-Polio Syndrome
                Cause of Post-Polio Syndrome
                Symptoms of Post-Polio Syndrome
                Post-Polio Syndrome Diagnosis
                Post-Polio Syndrome Treatment
                Post-Polio Syndrome Prognosis
                Post-Polio Syndrome Research
                Preventing Post-Polio Syndrome
                Post-Polio Syndrome and Exercise
Post-polio syndrome is a condition that affects some polio survivors many years after recovery from an initial acute attack of the poliovirus. Decades later, 25 percent to 40 percent of people who contracted paralytic poliomyelitis in childhood will develop:
               New muscle pain
               Worsening of existing weakness
               New weakness or paralysis.
Post-polio syndrome is not an infectious disease, and people who are experiencing it do not shed poliovirus.
What Causes It?
The cause of this condition is not known. However, research scientists believe the new weakness seen in post-polio syndrome is related to the damage of individual nerve terminals in the motor units that remain after the initial poliovirus infection.
 Risk Factors for Post-Polio Syndrome
While risk factors do not cause post-polio syndrome, certain factors can increase a person's risk for developing the condition. Risk factors include:
   Increasing length of time since acute poliovirus infection
Presence of permanent disability after recovery from the original polio virus infection
Being female.
Symptoms

The symptoms of post-polio syndrome can vary in number and severity between different people with the condition. Some patients experience only minor symptoms of post-polio syndrome, while others develop more severe symptoms.
             
Common post-polio syndrome symptoms can include:

               Slowly progressive muscle weakness
               Loss of muscle
               Unaccustomed fatigue
               Joint pain
               Increasing skeletal deformities such as scoliosis.
Diagnosing Post-Polio Syndrome

In order to make a diagnosis of post-poliosyndrome, the doctor will ask the patient a number of questions, perform a physical exam, and recommend certain tests looking for signs and symptoms of post-polio syndrome. Some of these tests may include:

  Magnetic resonance imaging (MRI)
                                  Computed tomography (CT)
                                  Neuroimaging tests
                                  Electromyography (EMG).
               
These tests can help diagnose post-poliosyndrome (or even another medical condition), but they do not identify survivors at greatest risk for new progression of muscle weakness.

Before making a diagnosis, the doctor will also consider other medical conditions that can share similar symptoms with post-polio syndrome. Some of these conditions include:

            Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease
             Depression
            Chronic fatigue syndrome.
Treatment Options

Currently, there is no cure for post-polio syndrome. Therefore, treatment is focused on relieving the symptoms. Some treatment options for this condition include lifestyle changes and support. Research scientists continue to actively look for other post-polio treatment options.


Post-Polio Syndrome and Exercise

Post-polio syndrome symptoms of pain, weakness, and fatigue can result from the overuse and misuse of muscles and joints. These same symptoms can also result from disuse of muscles and joints. This fact has caused a misunderstanding about whether to encourage or discourage exercise for polio survivors or individuals who already have post-polio syndrome.


(Click Post-Polio Syndrome and Exercise for more information.)
The Prognosis

Post-polio syndrome is a very slow, progressive condition marked by long periods of stability.

The severity of post-polio syndrome will depend on the degree of the weakness and disability that remained after an individual had the original polio attack. People who had only minimal polio symptoms from the original attack and subsequently develop post-polio syndrome will most likely experience only mild symptoms. People who were originally hit hard by thepoliovirus and were left with severe weakness may develop a more severe case of post-polio syndrome with a greater loss of muscle function, difficulty in swallowing, and more periods of fatigue.

(Click Post-Polio Syndrome Prognosis for more information.)


How Common Is Post-Polio Syndrome?

According to estimates by the National Center for Health Statistics, more than 440,000 polio survivors in the United States may be at risk for post-polio syndrome. Researchers are unable to establish a firm prevalence rate, but they estimate that this condition affects 25 percent to 50 percent of these survivors, or possibly as many as 60 percent.

¿Qué es Poliomielitis?





Las Enfermedades Infecciosas

La Poliomielitis (Polio)

¿Qué es la poliomielitis (polio)?
La poliomielitis es una enfermedad muy contagiosa causada por tres tipos de poliovirus. 
El poliovirus es un virus reconocido principalmente por destruir el sistema nervioso causando parálisis.
 Sin embargo, la mayoría de personas infectadas con polio, no tienen síntomas y algunas tienen 
síntomas leves. De todas las personas que tienen la infección, el 2 por ciento o menos pueden desarrollar
 una enfermedad paralítica. Desde la llegada de la vacuna contra la polio durante los primeros años de la 
década de 1950, las infecciones por el poliovirus han sido casi erradicadas. En países pobres, 
subdesarrollados y que no tienen acceso a la vacuna, la polio todavía es una preocupación principalmente
 para bebés y niños pequeños. La Organización Mundial de la Salud (su sigla en inglés es WHO) continúa esforzándose por erradicar el virus a nivel mundial.

 Los bebés y los niños pequeños forman el grupo de mayor riesgo.

Las infecciones por poliovirus son más comunes durante las estaciones de verano y otoño.

El riesgo de desarrollar parálisis por el virus aumenta con la edad.
¿Cómo se transmite el poliovirus?
La transmisión del poliovirus se produce más frecuentemente por la vía fecal oral. Usualmente ocurre debido al lavado de manos inadecuado o por el consumo de alimentos o agua contaminados. Las secreciones respiratorias también diseminan el poliovirus. Las personas infectadas con el virus pueden excretarlos en sus heces durante varias semanas. Los individuos son más contagiosos inmediatamente antes de que aparezcan los síntomas y poco tiempo después.
¿Cuáles son los síntomas de la poliomielitis?

Las infecciones por poliovirus pueden mostrar síntomas en varios grados de severidad. La mayoría de individuos (del 90 al 95 por ciento) no tienen síntoma alguno, lo cual se conoce como infección inaparente. Las otras tres categorías serán descritas más adelante.

A continuación, se enumeran los síntomas más comunes de la poliomielitis. Sin embargo, cada individuo puede experimentar los síntomas de una forma diferente. Los síntomas pueden incluir los siguientes:
La Poliomielitis abortiva
Un curso corto y leve de la enfermedad con uno o más de los síntomas siguientes:

Fiebre (hasta 103°F ó 39.5°C).

Apetito disminuido.

Náusea, vómito o ambos.

Dolor de garganta.

Malestar general.

Estreñimiento.

Dolor abdominal.
La Poliomielitis no paralítica

Los síntomas de la poliomielitis no paralítica son iguales a los de la poliomielitis abortiva, pero el dolor de cabeza, la náusea y el vómito pueden ser peores. Además, pueden ocurrir los siguientes síntomas:

El niño puede sentirse mal durante un par de días, luego parece mejorar y después vuelve a sentirse mal con los síntomas siguientes:

Dolor de los músculos del cuello, el tronco, los brazos y las piernas.

Rigidez del cuello y de la columna vertebral.

La Poliomielitis paralítica
Los síntomas de la poliomielitis paralítica son iguales a los de la poliomielitis no paralítica y la abortiva. Además, pueden ocurrir los siguientes síntomas:

Debilidad generalizada en los músculos.

Estreñimiento severo.

Músculos desgastados.

Respiración debilitada.

Dificultad para tragar.

Tos débil.

Piel ruborizada o manchada.

Voz ronca.

Parálisis de la vejiga.

Parálisis de los músculos.
¿Cómo se diagnostica la poliomielitis?

Además del examen y la historia médica completa, los procedimientos para diagnosticar la poliomielitis pueden incluir los siguientes exámenes:

Cultivos de la garganta, orina y heces.

Punción lumbar o espinal.

El recuento de que el niño no recibió la vacuna contra el polio o que no completó las series de vacunas contra dicha enfermedad.

Tratamiento de la poliomielitis:
El tratamiento específico para la poliomielitis será determinado por su médico basándose en lo siguiente:

Su estado general de salud y su historia médica.

Que tan avanzada está la enfermedad.

Su tolerancia a determinados medicamentos, procedimientos o terapias.

Sus expectativas para la trayectoria de la enfermedad.

Su opinión o preferencia.
Aunque existe prevención contra la poliomielitis, no existe cura para los individuos infectados. El tratamiento es de apoyo, que significa que los síntomas pueden tratarse para mejorar la comodidad y recuperación del paciente.
Tratamiento del dolor con analgésicos (como el acetaminofén).

Reposo en cama hasta que la fiebre disminuya.

Dieta adecuada.

Esfuerzo y ejercicio mínimo.

Compresas calientes o almohadillas calientes para el dolor en los músculos.

La hospitalización puede ser necesaria para las personas que desarrollan poliomielitis paralítica.

Las complicaciones de poliomielitis paralítica pueden incluir parálisis permanente de ciertos grupos musculares, incluyendo los músculos respiratorios y los de las piernas.

Prevención de la poliomielitis:
Higiene adecuada y lavarse bien las manos.

La inmunización contra el poliovirus: en Estados Unidos, se recomienda administrar la vacuna contra la polio a las edades siguientes:

2 meses.

4 meses.

Entre 6 y 18 meses.

Entre 4 y 6 años.

Pueden administrarse dos versiones de la vacuna:

IPV - Vacuna Inactivada contra la Polio que se administra por inyección (pinchazo).

La vacuna se administra completamente en las cuatro visitas. La administración de la IPV no puede causar polio y se puede usar en forma segura para individuos con sistemas inmunes debilitados.
OPV - Vacuna Oral contra la Polio que se administra por la boca.

En casos raros se ha conocido que la OPV cause poliomielitis paralítica asociada con la vacuna (su sigla en inglés es VAPP).

En enero del 2000, los Centros para la Prevención y el Control de las Enfermedades 
(Centers for Disease Control and Prevention, su sigla en inglés es CDC), el Comité Asesor para las Práctica de Inmunización (Advisory Committee on Immunization Practices, su sigla en inglés es ACIP), y la Academia Americana de Pediatría (American Academy of Pediatrics, su sigla en inglés es AAP) recomendaron que no se administre rutinariamente la OPV y que únicamente se administre IPV. Existen situaciones en las que es necesario que su hijo reciba la OPV, por ejemplo cuando viaje a países en los que puede transmitirse el poliovirus infeccioso o "silvestre".

La Vacuna Oral contra la Polio NO debe administrarse a los niños que:
tienen sistemas inmunológicos debilitados.

Toman esteroides a largo plazo.

 tienen cáncer.

tienen infección por VIH o SIDA.

tienen alergia a la neomicina, estreptomicina o polimixina B.

Editors of Canadian Medical Association Journal warn polio outbreak in Tajikistan could spread



25. June 2010 00:48
"A large polio outbreak in Tajikistan - Europe's first in years - has the potential to further spread the dangerous virus to other regions of the world, the [editors of] the Canadian Medical Association Journal [CMAJ] warned Wednesday" in an editorial appearing in the journal, the Canadian Press reports.
The CMAJ editors "suggested the outbreak, the largest since 2005 in a country where polio is not endemic, serves as a reminder that until polio is eradicated, the risk of renewed spread remains," the news service adds (Branswell, 6/23).
"There is no cure for polio, which can cause paralysis in a small percentage of infected children and adults," the Globe and Mail writes. "But the disease is entirely preventable through vaccination, which has helped eliminate it from many countries around the world," the newspaper reports (Weeks, 6/23).
CBC News, also reporting on the CMAJ editorial, notes the progression of the polio outbreak in Tajikistan, which grew from seven polio cases confirmed in children in April to more than 560 cases, including "183 that were lab confirmed" (6/23).
"'In all countries certified as polio-free, including Canada, the Tajikistan outbreak should be clanging alarm bells,' Dr. Noni MacDonald, the journal's public health editor, and editor-in-chief Dr. Paul Hebert wrote with the journal's advisory team," the news service writes (6/23).
The outbreak reflects "growing complacency over the need to vaccinate against the highly contagious disease, Hebert said in an interview," the Globe and Mail reports in a piece that examines how dips in vaccination rates can lead diseases to become reintroduced to a population (Weeks, 6/23).
"To minimize risks worldwide, we must first control the outbreak in Tajikistan and its surrounding area. With help from WHO, sequential mass polio vaccine campaigns are already under way in Tajikistan," the authors of the editorial (.pdf) write. "Other countries need to step up their vaccination rates so the overall rates exceed 90% in all communities. Worldwide surveillance for acute flaccid paralysis should be enhanced to ensure rapid early detection of spread from Tajikistan" (MacDonald/Hebert, 6/23).
"The Tajikistan outbreak is the latest in a string of setbacks for the global polio eradication initiative, the 22-year-old campaign aimed at permanently stopping the spread of the disease," the Canadian Press continues. "The campaign, jointly run by the World Health Organization, Rotary International, the U.S. Centers for Disease Control and UNICEF, has to date spent $8 billion trying to achieve the goal." The article notes that Afghanistan, India, Nigeria and Pakistan are the "[o]nly four countries remain on the list of nations that have never interrupted spread of polio."
The article includes comments from John Spika, director general of the Public Health Agency of Canada's Centre for Immunization and Respiratory Infectious Diseases, and Bruce Aylward, head of the WHO's polio eradication team.
Meanwhile, the Russian Health and Social Affairs Ministry recently confirmed seven cases of polio that "it says likely originate from an outbreak in Tajikistan more than one month ago," Radio Free Europe/Radio Liberty reports. "They are the first cases of polio in Russia in 15 years," according to the news service (6/23).
Low-Dose Polio Injectable Polio Vaccine As Effective As Full Dose, Study Finds
"Giving just one-fifth the usual dose of the polio vaccine may protect babies against the virus nearly as well as a full dose, as long as it is injected just beneath the skin," according to a study published Thursday in the New England Journal of Medicine, Reuters reports. "The findings could bring down the cost of immunization, an important consideration in developing countries, some of which have had trouble containing the paralytic disease," according to the news service.
For the study, which involved 373 children from Oman, researchers used a needle-free jet injector device "to deliver the vaccine beneath the skin at ages 2, 4 and 6 months. Blood tests showed more than 95 percent of the infants mounted an effective immune response against polio," the news service writes. Though infants who received the lower dose of the vaccine produced fewer antibodies against polio, the response was sufficient to offer infants protection against the disease (Emery, 6/23).
"Our study shows that intradermal administration of a fractional-dose inactivated poliovirus vaccine could serve as a dose-sparing strategy
when used in a primary routine vaccination schedule in which doses are administered at 2, 4, and 6 months of age," the authors of the NEJM study write (Mohammed et al., 6/24).
"The injectable vaccine costs about $3 per dose," Reuters continues. Though "[t]he oral polio vaccine is much cheaper, at about 15 cents, … it contains a weakened virus that can mutate and sometimes cause polio in patients or when it gets into sewage," which has led health experts to "favor the injectable vaccine," according to the news service.
"With this study, we know we can use this means to lower the price," study co-author Roland Sutter of the WHO said. "If we can do one-fifth the dose, we can at least get it down to one dollar, so we are getting into the neighborhood of a price that may be affordable for developing countries in the future."
The article includes information about the global challenges to eradicating polio and the WHO's polio eradication program, a topic touched upon in an accompanying commentary piece also featured in the New England Journal of Medicine (6/23).

Polio Film

http://www.pbs.org/wgbh/americanexperience/films/polio/

video

Salk Institute

Polio Video

Polio Lungs

https://youtu.be/qytuMHXDlds

Twitter

Enlaces

México Post Polio Una Vida Un Camino Una Experiencia
http://postpoliosinmex.blogspot.com/

Post Polio LITAFF A.C.

www.postpoliolitaff.org/
Postpoliolitaff.- Asociación Post Polio Litaff A.C Primera Organización oficial sobre Síndrome de Post Poliomielitis En México.


Polio y Efectos Secundarios SPP
http://polioyspp.blogspot.com/
- See more at: http://polioamigossinfronteras.blogspot.mx/#sthash.6PkHAkfM.dpuf

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March Of Dimes Polio History

Erradicación de La poliomielitis

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