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A very important increase in the costs of the edition of scientific journals has taken place in Venezuela, due to difficulties in obtaining imported free acid paper and other materials used for handling documents. Like other journals, Investigaci6n Clinica has been considering switching completely to a digital publication format; however there are several reasons that prevent us to doing it at this time: the journal is distributed in printed form to many national institutions, which do not have immediate access to digital information. In addition, there exists a commitment of shipment of printed issues for some international indices and in exchange with other national and foreign journals, whose printed format we receive. Another important aspect is that our University maintains a weak technological platform that makes difficult the immediacy required for the interchange with authors and consulted referees of received papers; and there is a latent danger of limitations in the use of digital technologies, due to current national politic problems. Consequently, we need to continue with the printed format, but must reduce the amount of printed issues, so as not to limit the number of papers published in each edition. Nevertheless, there is an ever increasing number of contributions from foreign researches and Investigaci6n Clinica has been recently included in two new international indices, the SEIIC from Argentina and the Infobase Index from India, reasons that obligate us to maintain our levels of excellence and commitment to our authors and readers.

Investigación Clínica has been published uninterruptedly for 55 years and for this reason, the University of Zulia has recognized the work of its editorial team with the imposition of the Order "Jesus Enrique Lossada". Despite some financial and structural problems we are optimistic because our journal has been included in new international indices and it is connected to the scientific world through the contributions from all continents; by the selfless collaboration of hundreds of domestic and foreign referees who respond with great professionalism; and through the visits to our website, from virtually around the world. Reviewing the SCImago statistical analysis, we found that among the Venezuelan medical journals, Investigación Clínica is first in cites per document (2 years) and second in the H index, and compares favorably with prestigious Latin-American journals. It is noteworthy that both in Venezuela and beyond our borders, the submission of topic reviews has increased in detriment of original papers or contributions. It seems that the lack of financial support to research institutes and universities, has led to a decline in experimental projects, at least in the medical field that occupies this journal, so researchers resort to reviews in their respective fields, as a compensation to maintain their productivity. This has caused that the Editorial Board has limited the reception of reviews to keep intact the percentage of published original contributions. Finally, we would like to think that there are no obstacles that can not be overcome to maintain our excellence in publishing Investigación Clínica.

During the past two years, Investigación Clínica has undergone a substantial reduction in its funding caused by the insufficient budget allotment that the University of Zulia has received from the Venezuelan Government. The progressive increase in the number of articles contained in each issue of the journal caused its weight to exceed the established limits, affecting the distribution costs. Therefore, some adjustments to its structure and distribution are required to maintain its frequency and quality, including reducing the number of papers per issue and sacrificing free shipping to many libraries and health centers in our country and abroad. The "Instructions to Authors" will appear only in the first issue and we will keep the "Index of Authors" in the last issue of the year. Also the publishing of reprints will be limited and only will be sent to authors upon request and shipment pre-payment. Likewise, color pages fees will be canceled to the Publishers, prior to printing. For the above mentioned difficulties, we recommend our regular readers to use the website https://sites.google.com/site/revistainvestigacionesclinicas/, where all articles can be found in PDF format, as they appear in our printed edition. Despite these difficulties, all our collaborators will keep working to maintain the high standards that have characterized this journal for over 50 years, inspired by our founder, Dr. Américo Negrette.