Spanish Medicine Research Articles

Developing and validating a prediction model of live birth following single vitrified–warmed blastocyst transfer

Research questionCan the developed clinical prediction model offer an accurate estimate of the likelihood of live birth, involving blastocyst morphology and vitrification day after single vitrified–warmed blastocyst transfer (SVBT), and therefore assist clinicians and patients? Study designRetrospective cohort study conducted at a Spanish university-based reproductive medicine unit (2017–2021) including consecutive vitrified–warmed blastocysts from IVF cycles. A multivariable logistic regression incorporated key live birth predictors: vitrification day, embryo score, embryo ploidy status and clinically relevant variables, i.e. maternal age. ResultsThe training set involved 1653 SVBT cycles carried out between 2017 and 2020; 592 SVBT cycles from 2021 constituted the external validation dataset. The model revealed that female age and embryo characteristics, including overall quality and blastulation day, is linked to live birth rate in SVBT cycles. Stratification by vitrification day and quality (from day-5A to day-6 C blastocysts) applied to genetically tested and untested embryos. The model's area under the curve was 0.66 (95% CI 0.64 to 0.69) during development and 0.65 (95% CI 0.61 to 0.70) in validation, denoting moderate discrimination. Calibration plots showed strong agreement between predicted and observed probabilities. ConclusionBy incorporating essential predictors such as vitrification day, embryo morphology grade, age and preimplantation genetic testing for aneuploidy usage, this predictive model offers valuable guidance to clinicians and patients, enabling accurate forecasts of live birth rates for any given vitrified blastocyst within SVBT cycles. Additionally, it serves as a potentially indispensable laboratory tool, aiding in selecting the most promising blastocysts for optimal outcomes.

New Optimized Academic Anti-BCMA CAR (CARTemis-1): How Does the Manufacturing Process Impact CAR-T Cell Features?

Introduction CAR therapy targeting BCMA (B-cell maturation antigen) is under research as treatment for multiple myeloma (MM). However, given the lack of a plateau in most studies, it becomes imperative to pursue more effective alternatives. BCMA downmodulation, the presence of soluble BCMA or the immune dysfunction observed in MM are some limitations that may affect efficacy. Next-generation CAR-T cells are being designed exploring new approaches to overcome restrictions to CAR-T efficacy in MM. We present a novel optimized anti-BCMA CAR (CARTemis-1) and its translation to the clinic. We have specifically focused on the study of the dynamics of the immunophenotype of CARTemis-1 along the manufacturing process, analyzing how these variables might impact the quality of the final product and influence the release decision. Materials and methods CARTemis-1 was evaluated in preclinical in vitro and in vivo models. CARTemis-1 generation from three healthy donors was validated under GMP-conditions in CliniMACS Prodigy with IL-7/IL-15. Flow cytometry was performed to characterize the immunophenotype along the manufacturing process. Quality controls of the final CARTemis-1 product were performed according to the criteria of the Spanish Medicine Agency. Stability of the final cryopreserved CARTemis-1 cell product was also analyzed. Results CARTemis-1 is a second generation anti-BCMA CAR that co-expresses the truncated epidermal growth factor receptor (EGFRt) as a transduction marker and suicide gene. Two different versions of CARTemis-1 were synthesized with different spacer regions (short vs long) with the long version showing significantly greater anti-myeloma function in vitro compared to the short version (p<0.001) (Figure 1A). During the preclinical validation, CARTemis-1 demonstrated potent anti-tumor capacity in vitro and in vivo, showing no susceptibility to the presence of soluble BCMA. Expansion with IL-2 or IL-7/IL-15 was compared (n=8), obtaining increased proliferation (mean 1.59x10 7 vs 3.07x10 7, respectively, p=0.002), increased stem cell memory and naïve population (mean 37.48% vs 43.95%, respectively, p=0.0052), and less PD1+LAG3+ levels (1.38% vs 0.55%, respectively, p=0.0338) with IL-7/IL-15. The generation of CARTemis-1 was validated under GMP-conditions closely monitoring the immunophenotype dynamics from leukapheresis to the final product. Through comprehensive evaluations, the optimal time-point for product release to achieve the best-fitness product was >6 (specifically, day 8-10) with reduced levels of exhaustion markers (Figure 1B) maintaining hallmarks of T cell activation and anti-tumor potency. In vivo biodistribution of CARTemis-1 cells was studied in mice models without myeloma cells, finding preserved tissue structure without relevant morphological alterations in brain, cerebellum, intestine, lung, endometrium, ovary, testicle, spleen, and liver. We performed graft-versus-host disease (GVHD) in vivo mice models and found no increase in GVHD incidence following CARTemis-1 inoculation. Additionally, we assessed the cryopreserved product stability, and it met all specifications and retained its functionality for up to 12 months after cryopreservation. With this positive outcome and having obtained the approval of the Spanish Medicine Agency, we plan to proceed with a phase I/II clinical trial using CARTemis-1 for patients with multiple myeloma who have experienced relapse following allogeneic transplantation (EudraCT 2021-001955-15). Conclusions CARTemis-1 has been rationally designed to increase anti-tumor efficacy and overcomes sBCMA inhibition. To our knowledge, this is the first study analyzing the impact of the manufacturing process in the dynamics of the CAR-T immunophenotype highlighting the importance of the immunophenotypic characterization of CAR-T cells throughout the manufacturing process to define the optimal cell culture protocol and expansion time to increase CAR-T cell product fitness.

Bawds, Midwifery, and the Evil Eye in Golden Age Spanish Literature and Medicine

This article explores the relationship between the alcahueta or bawd, the evil eye, and midwifery in the early modern Spanish cultural imaginary. The evil eye, though an ancient belief, received renewed attention in theological and medical texts, including midwifery manuals, from the late fifteenth until the mid-sixteenth century, coinciding with the popularity of texts such as La Celestina featuring bawds. This article explores cultural debates regarding whether the evil eye was a natural phenomenon caused by corrupted bodily fluids emanating from post-menopausal women, or a result of witchcraft. Midwifery manuals list the evil eye as one of the principal dangers to newborns and give advice regarding how to prevent it, perhaps implicitly providing another justification for women’s gradual exclusion from midwifery in the early modern period. Fictional texts portray the bawd as engaging in women’s healing practices such as midwifery and newborn care, and as casting and curing the evil eye. I argue that the literary archetype of the bawd-midwife reflects academic disagreements that alternatively portray the evil eye as a physical illness, superstitious nonsense, or the result of witchcraft. As such, the bawd becomes a focal point for expressing anxiety over perceived decadence and decline, often tied to witchcraft. By tracing the evil eye through the characterization of bawds, we can perceive subtle indications of ambiguity regarding women’s magical and medical practices that question whether their influence comes from the devil or from women’s inherently malevolent nature.

Controlling Healthy Populations: Medicine, Biopolitics, and Racial Politics in Spanish New Orleans, 1763–1803

Controlling Healthy Populations:Medicine, Biopolitics, and Racial Politics in Spanish New Orleans, 1763–1803 Liana DeMarco (bio) Sometime in early August 1794, a free woman of African descent named Margarita Goton faced off against her former enslaver and current employer in a courtroom in Pensacola, Florida. Goton alleged that Dr. Juan Rubí, first surgeon of the Spanish Royal Hospital of Pensacola, was refusing to pay her the remaining balance of her wages from ten years' work at the hospital. Rubí had already captured the vast majority of Goton's earnings per her contract to become coartada, or legally no longer a slave. Rubí had purchased Goton in New Orleans in 1781, but in 1784 the two agreed that Rubí would emancipate Goton after she paid him the equivalent of her market value. Ten years later the price was paid and she had her freedom, but by her calculations Rubí had taken 1,235 pesos on top of the coartación sum he had agreed to. At one point, Goton threatened to withhold her labor until she received her money, stating that she "would not spend any more time in service of the hospital and would retire that very night." She would accept being paid in installments, but, according to the court record, she wanted Rubí "to certify her total payment in writing so that if there were any more delays in her payments, she would have the official record she needed to get the money she was owed." Goton's confidence in the courtroom stemmed from her understanding that people like her were essential to Spanish colonial medicine and public health. She worked in a colonial hospital similar to those in New Orleans, Baton Rouge, and Havana where, more often than not, enslaved and free people of African descent did the vast majority of everyday work, from sweeping the floors to treating patients. Nonetheless, Juan Rubí refused flat out to pay her, arguing that he had a right to all of Goton's wages after being, in his words, "so liberal and generous in giving [End Page 447] her freedom at price and without interest." He declared Goton's threats meaningless, saying that the hospital did not need her labor. Goton, who clearly believed the exact opposite, was caught off guard.1 This legal case illuminates key themes in the history of medicine and public health in the late-eighteenth-century Spanish Atlantic world. Spanish medicine was moving away from its traditional basis in Iberian scholasticism, as its practitioners became more interested in using reason to reveal rational explanations for the human body, illness, and disease.2 Yet historians of Spanish colonial medicine in Mexico, Peru, and Guatemala have shown that people of African descent and Indigenous people were heavily involved in the Spanish state's efforts to heal the sick, fight infectious disease, and extract local medical knowledge. For example, colonial officials often worked with Indigenous medical practitioners during smallpox inoculation campaigns in Guatemala and Peru, not just because the Spanish needed the labor, but also because they recognized the skills of Indigenous practitioners and the efficacy of their medical knowledge.3 Similar social dynamics existed along the Spanish Gulf Coast of North America, and especially in New Orleans, where people of African descent were the backbone of colonial medicine and public health. Between 1763 and 1803, New Orleans was not only a military outpost for the Spanish empire but also a pivotal site of state-led biopolitical projects and transformations in medical authority. The Spanish believed that the management of healthy, racialized populations—what I call [End Page 448] here biopolitics—was essential for the economic development of New Orleans and Louisiana as a whole.4 Upon claiming the city from the French after the Seven Years' War, Spanish officials set out to order the urban landscape and to expand the medical and public health infrastructure to support growing populations of enslaved laborers and white settlers. To do so, they relied heavily on the labor of free and enslaved people of African descent, but not out of pragmatism alone. For centuries, people of all backgrounds in the Spanish Atlantic had trusted medical practitioners of African...

Relics and Historical Uses of Human Zootherapeutic Products in Contemporary Spanish Ethnoveterinary Medicine.

(1) Background: this review documents the wide repertoire of practices and remedies based on the use of human-derived products in Spanish ethnoveterinary medicine (EVM) from the early 20th century to the present. These practices are compared with historical data and those of other countries; (2) Methods: a search using advanced functions in the most important databases in the fields of ethnobiology, EVM, folklore, and ethnography was performed. Information was obtained from 29 documentary sources; (3) Results: from the search of the literature, 46 use-reports related to the veterinary use of human urine, menstrual fluid, saliva, breast milk, and faeces were recorded. These zootherapeutic resources are/were used to treat 20 animal diseases, in particular dermatological ailments. In addition, many practices of the magical–religious type are documented; (4) Conclusions: the veterinary uses described and analysed here are fundamental to the development of therapeutic tools and creating teaching and learning processes in new popular veterinary practices adapted to the users and those who demand them. The information collected could form a scientific foundation for future inventories of local veterinary knowledge (LVK) and research addressing the discovery of new drugs for livestock. This work contributes to the inventory of some uses, traditional practices, and rituals seriously threatened by the progressive loss of LVK in Europe.

Searching for Scientific Explanations for the Uses of Spanish Folk Medicine: A Review on the Case of Mullein (Verbascum, Scrophulariaceae).

Verbascum species (common mullein) have been widely used in Spanish folk medicine to treat pathologies related to the musculature, skeleton, and circulatory, digestive, and respiratory systems, as well as to treat infectious diseases and organ-sense illnesses. These applications support the potential anti-inflammatory action of Verbascum phytochemicals. Based on the aforementioned facts, and following a deep bibliographic review of the chemical composition of the 10 species of Verbascum catalogued by the Spanish Inventory of Traditional Knowledge related to Biodiversity, we look for scientific evidences to correlate the traditional medical uses with the chemical components of these plants. To support these findings, in silico simulations were performed to investigate molecular interactions between Verbascum phytochemicals and cellular components. Most of common mullein traditional uses could rely on the anti-inflammatory action of phytochemicals, such as quercetin, and it could explain the employment of these plants to treat a wide range of diseases mediated by inflammatory processes such as respiratory diseases, otitis, arthrosis, and rheumatism among others.

Reflection on Telemedicine Competencies in Spanish Medicine Degrees After the COVID-19 Pandemic.

The pandemic suffered in 2020 following the appearance of the SARS-CoV-2 virus has marked a radical change in the way in which the basic pillars of international, and more specifically Spanish, society are understood. The existing social and economic model has had to adapt abruptly and urgently to the reality of what has happened. The impact that these changes will have after the pandemic is still unclear, but it may be surmised that many of them are here to stay. The use of information and communication technologies has been critical in the pandemic scenario and also in the health environment, where factors like telemedicine have come to play a key role for society. This work presents an initial analysis of how degrees in Medicine train students for telematic work with patients and provides a series of reflections based on the pandemic which may serve as a point of departure for future studies.

Ethnobotanical Research and Compilation of the Medicinal Uses in Spain and the Active Principles of Chiliadenus glutinosus (L.) Fourr. for the Scientific Validation of Its Therapeutic Properties.

The species Chiliadenus glutinosus (L.) Fourr. has a large number of therapeutic uses reported in the traditional Spanish medicine. The growing interest in preserving the ethnopharmacological knowledge related to the botanical diversity existing in Spain and the interest in achieving scientific validation of the therapeutic properties of medicinal species has led to the development of this study. To do it, all the known medicinal uses of Ch. glutinosus in Spain were compiled, then an exhaustive bibliographic research on its chemical composition was carried out, and finally, an in silico validation of the bioactive phytochemicals present in a higher proportion in the essential oil of Ch. glutinosus: camphor, borneol, lucinone, glutinone, quercetin, kutdtriol, and kaempferol; in an attempt to justify the reported traditional uses of the species. It was found that much of the traditional medicinal uses of Ch. glutinosus, along with the biological activity of its phytochemicals, are supported by scientific evidence. The results place this species in a prominent position to initiate possible lines of research to develop new, more effective drugs and improve therapies to treat conditions and diseases that affect the different organic systems of the human being.

Forensic research on sudden death published in Spain

IntroductionOne of the main pillars of the work of legal medicine in Spain is research. Taking sudden death (SD), a classical subject in forensic pathology, as the reference this paper aims to examine developments in Spanish forensic research papers published in the two most relevant Spanish legal medicine journals. MethodsArticles on SD over the last 10years from the two most relevant Spanish forensic journals were gathered. An international journal with medium-intermedium impact factor (second quartile in 2018) was the comparator. A third open search of PubMed indexed medical journals was conducted to detect and treat potential derivative bias. Results and discussionCardiac SD is the most studied SD at a national level, with high rates of collaboration among centres and specialties. However, this does not result in higher rates of original papers, but in more special articles and case-reports. At an international level, case-reports are the main publication format followed by original articles, mainly focussing on non-cardiac SD. ConclusionsAs a prospect for the future, we suggest strengthening policies to promote research and, above all, to create collaboration networks among specialties towards a multidisciplinary, preventive and clinical approach to SD research.

Luchando contra la COVID-19: labor asistencial de los médicos rehabilitadores españoles. Estudio transversal

ObjectiveThe aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic. MethodsA survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period. ResultsA total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%). ConclusionsThe organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians.

Characterization of Burnout Among Spanish Family Physicians Treating Fibromyalgia Patients: The EPIFFAC Study

Burnout among physicians has increased, affecting not only doctors but also the quality of patient care. Treating challenging disorders, such as fibromyalgia, may increase the risk of feeling burned out. Health care of fibromyalgia patients is increasingly being assigned to family physicians. Therefore, we described the demographic characteristics, work contexts, component burnout scores (exhaustion, depersonalization, and personal accomplishment), and perceptions of fibromyalgia care of Spanish family medicine physicians with high and low levels of burnout. We then evaluated which of these variables were associated with having high or low levels of burnout. This cross-sectional study assessed 506 family physicians recruited from the Spanish Society of Family Physicians and randomly selected from Primary Health Care Centers. The subgrouping of family physicians based on their burnout scores was assessed by cluster analysis. Variables showing statistically significant differences between clusters and significance below 0.25 in univariate logistic regressions were assessed by multivariate logistic regression analysis. Family physicians reporting higher burnout scores (25%) felt that fibromyalgia patients on sick leave increased their workload, reported no support from nurses in the treatment of fibromyalgia patients, and had a more negative impression of fibromyalgia patients. One-quarter of family physicians reported feeling exhausted, detached from fibromyalgia patients, or less professionally accomplished. Several personal characteristics and contextual variables increased burnout. Several interventions to modify these variables and, thus, protect family physicians treating fibromyalgia from burnout are suggested.

A proprietary GMP-manufactured human platelet lysate: two-year stability study

Background & Aim Human platelet lysate (hPL) has long been used as a xeno-free culture supplement to expand different cell types. Its use is currently thriving given its potential therapeutic properties and its increasing importance in a clinical manufacturing context; however, to date, data regarding the stability of HPL solutions is limited. The general chapter Raw materials for the production of cell-based and gene therapy medicinal products (EP 5.2.12), gives examples of the critical quality attributes specific to each class of raw material. The aim of these studies has been to stablish the expiration time of our product in specific storage conditions. Methods, Results & Conclusion Five batches of our clinical grade hPL currently accredited by Spanish Medicine Agency, were selected for stability testing. Cells were culture (with 5%, 10% and 15% hPL) to analysed the stability of the supplemented medium with Hpl at 4 degrees. The two-year stability study has included the following controls: sterility, mycoplasma, adventitious viruses and endotoxin, activity test, pH, PDGF-AB, total proteins, albumin and IgGs. Sterility, mycoplasma, adventitious viruses and endotoxin level were performed after manufacturing (time 0) and after 24 months while activity test, pH level, PDGF-AB, total proteins, albumin and IgGs concentration were determined from each batch immediately after manufacturing (time zero) or after storage at -80 degrees for 6, 12 or 24 months. All the controls were performed according to European Pharmacopoeia if exist or according to approval procedures. No significant differences were observed regarding the proliferation capacity of fibroblasts cultured with 5%, 10% and 15% hPL for at least 40 days, maintaining the activity in culture. All microbiological controls met the acceptance criteria established to the validation at two years. No significant differences were observed in fibroblasts doubling time when we compared hPL solution and FBS at time 0 and after 24 months. PDGF-AB and pH remained stable at −80 degrees. Besides, total proteins, albumin and IgGs neither showed significant changes along 2 years. Here we show that our hPL solution remains stable in the supplemented medium for 40 days at 4 degrees without significant loss of activity and for 2 years at -80 degrees, maintaining its growth promotion activity in cells, pH and PDGF-AB levels, total proteins, albumin and IgGs concentrations, being an attractive alternative to commercial solutions for cell culture in a clinical context.

Hospital exemption: a challenging milestone for the Andalusian Public Healthcare System

Background & Aim Advanced therapy medicinal products (ATMPs) are a particularly novel class of medicines, which include gene and cell therapies, and tissue engineered products. Patients can access to ATMPs through clinical trials (research phase), authorized market drugs, hospital exemption or exceptionally under compassionate use. To reach the marketing authorization for ATMPs it is needed to follow the centralised procedure stablished by the Regulation (EC) No 1394/2007. In addition, the article 28 of this Regulation concerning to “hospital exemption” was included to recognize the small scale and developmental nature of the activities carried out in some hospitals, which calls for a degree of flexibility in the nature of regulatory requirements. This article establishes the exemption as follow “ATMPs prepared on a non-routine basis according to specific quality standards, and used within the same Member State in a hospital under the exclusive professional responsibility of a medical practitioner, in order to comply with an individual medical prescription for a custom-made product for an individual patient”. In agreement with this article, the hospital exemption ensure the accessibility and sustainability of the Public Health Care System without the use of non-commercialize products. Methods, Results & Conclusion In Spain, according to Royal Degree 477/2014, Hospital exemption request must be submitted using the Common Technical Document (CTD) structure, consists of five modules where set of specifications for an application dossier for the registration of Medicines. In this sense, The Andalusian Network for the Design and Translation of Advanced Therapies (AND&TAT) which belongs to the Andalusian Health Care System and coordinate a network of 10 GMP facilities, has leading the Hospital exemptions submissions in several Andalusian Hospitals a challenging activity for an Academic Institution with limited resources. To date, three requests from three different Hospitals have been presented to Spanish medicine agency and are pending on some clarifications to be approved. In parallel, efforts are ongoing to submit another three dossiers which pretend to be presented in near future.

Exploring Health Science Students’ Notions on Organ Donation and Transplantation: A Multicenter Study

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. ObjectiveTo determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. Methods and Designand design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. ResultsThe completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). ConclusionOnly 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.

Investigación forense sobre muerte súbita publicada en España

IntroductionOne of the main pillars of the work of legal medicine in Spain is research. Taking sudden death (SD), a classical subject in forensic pathology, as the reference this paper aims to examine developments in Spanish forensic research papers published in the two most relevant Spanish legal medicine journals. MethodsArticles on SD over the last 10 ears from the two most relevant Spanish forensic journals were gathered. An international journal with medium-intermedium impact factor (second quartile in 2018) was the comparator. A third open search of PubMed indexed medical journals was conducted to detect and treat potential derivative bias. Results and discussionCardiac SD is the most studied SD at a national level, with high rates of collaboration among centres and specialties. However, this does not result in higher rates of original papers, but in more special articles and case-reports. At an international level, case-reports are the main publication format followed by original articles, mainly focussing on non-cardiac SD. ConclusionsAs a prospect for the future, we suggest strengthening policies to promote research and, above all, to create collaboration networks among specialties towards a multidisciplinary, preventive and clinical approach to SD research.

Gaspar Casal en la medicina española del siglo XVIII

Gaspar Casal en la medicina española del siglo XVIII

Bioactive Phytochemicals from Mercurialis spp. Used in Traditional Spanish Medicine.

Plants from the genus Mercurialis have a long history of use as herbal remedies in traditional Spanish medicine. The growing interest in the conservation of knowledge related to biodiversity has encouraged us to review the bioactive phytochemicals from the four most widespread Mercurialis species in the Iberian Peninsula (M. annua L., M. ambigua L., M. perennis L., and M. tomentosa L.). First, the medicinal uses of these four species throughout Spain were compiled, and then a bibliographical search on their chemical composition was conducted in an attempt to justify their reported traditional uses. We found that most of the medicinal uses of Mercurialis spp. are supported by scientific evidence. This includes its antidiabetic and antihypertensive properties attributable to the flavonoid rutin and narcissin, respectively; its benefits in the treatment of skin dark spots, attributable to mequinol; and its anti-inflammatory activity, attributable to scopoletin, kaempferol, squalene, and cycloartenol. This review contributes to the validation of the medicinal uses of Mercurialis spp. in Spain and provides some new avenues for further investigations on the biological activity of this interesting medicinal plant.

Meet the First Authors.

Meet the First Authors.

Medical Martyrs: Nineteenth-Century Representations of Early Modern Inquisitorial Persecution of Spanish Physicians

Abstract This essay examines the discourse on medicine and the Inquisition in nineteenth-century Spain. It traces how liberal reformers selectively appropriated aspects of the history of Spanish medicine in the service of their contemporary political and scientific agendas, and how in doing so they contributed to the formation of new professional and national identities.

The personal and professional face of the Basque urologist José Julián Guimón Rezola (1898–1980)

ObjectiveTo understand certain outstanding aspects of the life of the Basque surgeon and urologist Julián Guimón Rezola. His personal and bibliographic documentary legacy helps reconstruct his works and personal character. Material and methodsWe analysed the written works of Julián Guimón Rezola and a collection of documents, letters, photographs, illustrations and objects from his personal and professional life, accessed through his family. We analysed the content of the author's main publications and related the documents to historic facts. ResultsJulián Guimón Rezola was an upstanding individual, a father, a family man and a nationalist before the struggle, who was dedicated to his work and particularly to teaching and health management. He started his urological career under the direction of Francisco Pérez Andrés in the Santo Civil Hospital of Bilbao. He endured unjust repression for participating in the creation of the Basque University in 1936. Sentenced to life imprisonment, he stated a new life as a reclusive surgeon in the prison of Puerto de Santa María. He was pardoned three years later but was deprived of all his offices and disqualified from civil service. He founded his clinic and maintained his training in the United States. He presided over the Medical-Surgical Insurance Group of Bilbao (Igualatorio Médico-Quirúrgico) and, on 2 occasions, the Bilbao Academy of Medical Sciences. He was considerably active professionally and focused on social medicine and modern urology. He wrote 104 scientific articles, a number of which were of considerable quality and impact. We observed an evolution in the subject matter of these articles, all with exquisite professionalism and humanity. He corresponded with renowned practitioners and was admitted to the Spanish Royal National Academy of Medicine in 1970. He ended his career with an appointment as honorary professor at the University of the Basque Country 2 years before his death. ConclusionsSurgeon urologist Julián Guimón Rezola was a fundamental figure in Basque and Spanish medicine in the 20th century. He was the victim of a severe reprisal, not so much for political issues but rather for his institutional loyalty. However, he regained his professional and academic prestige. His written works reveal modern medicine with a considerable social foundation and the mind of a brilliant health manager.