Gac Med Mex
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In Mexico, the complexity of the comprehensive care of a girl, boy or adolescent who is the victim of any form of child abuse requires the necessary legal knowledge for comprehensive management. Physicians probably lack sufficient knowledge of the laws to understand and correctly address the legal aspects immersed in the comprehensive care of this population group. ⋯ The purpose of this article is to present the existing legal framework in Mexico and the actions of world organizations in this area. It is necessary for the Political Constitution of the United Mexican States to be the basis on which legal behaviors related to child abuse, crime investigation and administration of justice are founded, as well as for international agreements on the subject, which have been signed by the government of Mexico, to be adhered to.
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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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Common variable immunodeficiency (CVID) is the main symptomatic primary immunodeficiency and is associated with complex immune disorders. Gut microbiota interacts closely with the immune system, and intestinal dysbiosis is related to multiple diseases. ⋯ Unlike healthy subjects' gut microbiota, where Firmicutes and Bacteroidetes predominate, the microbiota of the patients with CVID considered in this study was abundant in Firmicutes, Actinobacteria and Verrucomicrobia. The low presence of Bacteroidetes and high abundance of Firmicutes might indicate the existence of intestinal dysbiosis in these patients.
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Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective vaccination prevents the occurrence of serious cases and decreases mortality. ⋯ Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.