Gac Med Mex
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A clinical research question requires the concurrence of clinical experience and knowledge on methodology and statistics in that who formulates it. Initially, a research question should have a structure that clearly establishes what is that which is being sought (consequence or outcome), in whom (baseline status), and by action of what (maneuver). Subsequently, its reasoning must explore four aspects: feasibility and reasonableness of the questioning, lack of a prior answer, relevance of the answer to be obtained, and applicability. ⋯ One should never forget that every maneuver entails adverse events that, when serious, discredit good results. It is imperative to have the possible answer estimated from within the structure of the question. The function of clinical research is to corroborate or reject a hypothesis, rather than to empirically test to find out what the outcome is.
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Comparative Study
Eventos adversos en una nueva unidad de cuidados intensivos. Influencia del diseño y la tecnología de las instalaciones en las tasas de incidencia.
New hospitals are replacing old facilities. There is little information on the performance of an intensive care unit (ICU) when it is relocated in a new and equipped area. ⋯ In comparison with the f-ICU, most of the monitored adverse events did not significantly change within the first 18 months of activities at the n-ICU.
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Review Historical Article
Desde el ISET al InDRE. II. Instituto de Salubridad y Enfermedades Tropicales: madurez y consolidación, 1940-1964.
The period that starts in 1940 is crucial for the creation of Mexico's modern health system. The Institute of Sanitary and Tropical Diseases is the pioneer institution in health research and on its first two decades it achieved maturity and consolidated lines of research expressed in almost 1700 publications. ⋯ It faced limitations to renew lines of research, researchers and laboratory equipment. However, its role in public health decisions of the country remained central.
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The physician that has the first contact with the patient is the general or family doctor, on whose initial assessment patient treatment success often depends. National and international treatment guidelines are designed for specialists in the area, and the primary care physician often finds them difficult to interpret. The purpose of this document is to offer primary care physicians the fundamentals for the diagnostic and reference process of patients with thyroid nodules and possibly with well-differentiated thyroid cancer, from an objective and pragmatic point of view. ⋯ The bases for a proper diagnosis of a thyroid tumor are patient history, physical examination and ultrasound. The results of these three initial assessment methods shall support the decision on the diagnostic-therapeutic process. This article explains the appropriate way to approach the diagnosis of a thyroid tumor, which studies are unnecessary, and which are the principles of thyroid cancer treatment.
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Research ethics must include theoretical and practical dimensions. The first one is structured by regulations and policies, and the second dimension refers to how the committee interprets and applies those regulations and policies. This article analyses the operation of the committees at a practical level. Given that the evaluation and judgement of research protocols is a process that requires full awareness, its omission entails important implications for health research.