Spanish Society Research Articles

Contributions to the development of an anatomical terminology in Spanish from South America.

The development of a standard anatomical language in Spanish dates back to the early stages of medicine, and its significance lies in the necessity for a common vocabulary to describe the structures of the human body. Anatomists and morphologists have been striving to achieve this goal since the late nineteenth century when the first Anatomical Nomenclature was created in Basel in 1895. Over the years, various versions of the International Anatomical Terminology have been published in Spanish, following the guidelines of the International Federation of Associations of Anatomists (IFAA). These versions have been produced in partnership with the Spanish Anatomical Society and have aimed to adjust the terms to the Spanish language and linguistic rules. The Ibero-Latin American Symposia on Anatomical, Histological, and Embryological Terminology (SILAT) have embraced the naming of morphological structures, keeping in mind the Latin and Greek roots, while respecting the translations accepted by the linguistic rules of the official languages. These symposia stick to the principles of universality, precision in structure description, and consistency in terminology. Despite more than a century of progress in anatomical terminology, there is a need for frequent revisions and adjustments to anatomical terms, particularly when translating them into various languages and because of the high number of international publications related to anatomy. A shared anatomical language is essential for the study and application of anatomy across various medical practices and in undergraduate education. Finally, the establishment of anatomical terminology in Spanish represents a long history of efforts to create a universal and precise language in this field. Despite advancements, the revision and adaptation of anatomical terms remain a continuous challenge to keep up with scientific progress and ensure effective communication in the field of anatomy.

How social and economic conditions impact socioeconomic mobility. The case of Spain

We rely on Permanent Income to define a socioeconomic stratification system based on a latent trait measurement model using objective and widely available socioeconomic variables as reflective indicators, with an official panel of households spanning 2006–2020 in Spain. We obtain an objective and transparent stratification of Spanish society for these 15 years, and track social mobility at the household level between consecutive years that included economic expansion, a major recession, economic recovery and a major pandemic.We have quantified social mobility (greater in the extreme strata) in each of the periods of growth, crisis and economic recovery. Crisis derived from COVID-19 has been more drastic and has affected more the consumption of households under 65 years of age or with few members. In Spain, measures adopted against the effects of the COVID crisis have generated less inequality than those adopted during the Big Recession of 2008.

English

The social changes related to gender identity that have been taking place in recent years have a notable and growing impact on sports practice. The incorporation of people with sex reassignment, transsexuals, and intersex (different sexual development) in sports competition raises issues that until now were very rare and relevant but that are currently causing doubts, debate, and controversy. The Spanish Society of Sports Medicine (SEMED), aware that this issue has important repercussions, both on the professional practice of physicians who care for athletes, and on the health of the athletes themselves, understands that it is necessary to deepen the knowledge of the sports practice of people with sex reassignment, transsexuals and intersexuality and considers it appropriate to make an official position on this issue. This work addresses sex reassignment, transsexuality, and intersexuality, shedding light on their definitions, their prevalence, and the differences in sports performance between men and women. He also considers it important to make a reference to the forms of classification in sport, as well as the role of androgens (testosterone and dihydrotestosterone, DHT) in sport. It analyzes the sports participation of people with sex reassignment, transsexuals and intersexuals since the emergence of the Caster Semenya case to end with the positioning of the Spanish Society of Sports Medicine and the recommendation on actions proposed to the sports authorities on addressing the sports participation of people with sex reassignment, transsexuals, and intersex from the perspective of the functional, injury and incentive consequences of women's sports practice.

Identification and sensitization to environmental fungal spores in Lima City, Peru

To identify and registry the most important fungal spores trapped in our aerobiology station, as well as to report the prevalence of skin sensitization to these allergens. The pollen counts were made according to standardized technique with a Burkard seven days spore trap, following the American Academy of Allergy, Asthma and Immunology (AAAAI) through National Allergy Bureau (NAB) recommendations. The trap was installed on the roof of Clinica SANNA, El GOLF, San Isidro, which is 20 m high, 12°5'54"S 77°3'6"W in the west-south of the Lima urban area. The sampling period was performed from September 2020 to October 2021. Skin prick tests were carried out according to the recommendations of the Spanish Society of Allergology and Clinical Immunology (SEAIC) in 200 patients (18 to 60 years old) with symptoms of rhinoconjunctivitis and/or asthma, who were evaluated in the Allergology Service of Clinica SANNA el Golf. Allergenic extracts were applied, dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), cat and dog danders, cockroach (Periplaneta americana), grass 6 mix, weed mix, molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Nigrospora spp.), INMUNOTEK-Spain provided the extracts. We also tested other fungal allergens such as Fusarium spp, Stemphylium spp, Curvularia spp, a mixture of Helmintosporum/Dreschlera spp. from the DIATER-Argentina laboratory. We identified spores of Alternaria alternata, Cladosporium spp., Nigrospora spp., Stemphylium spp., Fusarium spp., Curvularia spp., Dreschlera/Helmintosporum spp. The patients showed sensitization to Cladosporium herbarum (14%), Fusarium spp. (13,5%), Nigrospora spp. (8%), Alternaria Alternata (7%), Stemphylium (6%), Dreschlera/Helmintosporium spp. (5,5%), Curvularia spp. (3%), Aspergillus fumigatus (2,5%). The inhabitants of the south-western area of the urban city of Lima are exposed to different fungal spores with allergenic potential, with a higher concentration being identified during the summer/autumn months. Cutaneous sensitization is demonstrated in variable percentages to the fungal spores identified in this aerobiological sampling. The results of this study should be expanded and compared with data in the forthcoming years, identify seasonal and annual fluctuations and extend the traps to other locations in Lima.

Diagnosis and treatment of deep vein thrombosis of the lower and upper limbs. 2024 recommendations of the venous thromboembolism group of the Spanish Society of Internal Medicine

Deep vein thrombosis (DVT) of the limbs is a common disease and causes significant morbidity and mortality. It is frequently the prelude to pulmonary embolism (PE), it can recur in 30% of patients and in 25–40% of cases they can develop post-thrombotic syndrome (PTS), with a significant impact in functional status and quality of life. This document contains the recommendations on the diagnosis and treatment of acute DVT from the Thromboembolic Disease group of the Spanish Society of Internal Medicine (SEMI).PE and thrombosis of unusual venous territories (cerebral, renal, mesenteric, superficial, etc.) are outside its scope, as well as thrombosis associated with catheter and thrombosis associated with cancer, which due to their peculiarities will be the subject of other positioning documents of the Thromboembolic Disease group of the Spanish Society of Internal Medicine (SEMI).

Antiviral treatment for SARS-CoV-2 infection in the current situation: a position paper of the Spanish Society of Emergency Medicine (SEMES).

COVID-19 continues to pose a significant threat: mortality stands at nearly twice that of influenza, and the incidence rate is growing as the population's vaccination rate decreases, particularly in Spain and other areas of Europe. Given this situation, it is vitally important know whether medical protocols are consistent and appropriately implemented by health care staff in the interest of preventing possible inefficiency or inequity. Physicians from hospital emergency departments met to study their hospitals' usual clinical practices for managing SARS-CoV-2 infection and to determine their expert opinions on the use of antiviral agents. The participating physicians then reached consensus on evidencebased recommendations for strategies that would optimize emergency treatment.

Energy co-operatives in Spain: The role of social enterprises in the energy transition

Decentralized and small-scale forms of organization are reappearing in Spanish’s energy system. Co-operatives have a social approach based on three dimensions: the purpose of the initiative, the form of organization and ownership, and embeddedness. In this paper, we apply this analytical framework to twelve energy co-operatives in Spain. These collectively owned organizations are energy-marketing communities, and they have specific objectives: These are an ecological objective (to reduce energy consumption and generate renewable energy) and a social objective (to propose an alternative to the reality of the energy market and citizen empowerment). Energy co-operatives in Spain have been typified as social enterprises, and these social enterprises have experience in common energy service, with which they may mark their future role in local energy communities. These results show the consolidation of energy co-operatives as a sign of the maturity of Spanish society in the face of energy challenges.

Multiple Sclerosis Treatment and Holistic Patient Care Consensus by the Spanish Society of Neurology (P3-6.013)

Multiple Sclerosis Treatment and Holistic Patient Care Consensus by the Spanish Society of Neurology (P3-6.013)

Emotional and relational realms of unaccompanied migrant adolescents: an approach to their lived experiences

After the arrivals of unaccompanied migrant adolescents to Spain reached their peak in 2018, the trends have varied in the last few years, significantly decreasing in 2019 and slowly starting to increase again in 2020. These adolescents represent one of the most vulnerable groups due to their unique characteristics closely linked with the stressors encountered in their migratory process and the host society. All these experiences have been found to affect their well-being in different domains; however, very little is known about their perception of the matter, which is critical to understanding their needs and perspectives. This paper aims to look into the lived experiences of these children and how this process has affected their relational and emotional spheres, which are paramount to their development, especially during adolescence. These experiences were gathered using qualitative methodology consisting of interviews and focus groups conducted in a reception centre for unaccompanied migrant children in Catalonia. The view of these children is enriched with the contributions of the staff working in the reception centre. Analysis of the verbatims yielded six main topics revolving around frustrated expectations, obtention of legal documents, freedom, contact with the Spanish society, family and mental health. These are discussed considering how they affect emotional and relational well-being in the three stages of the migration process.

English in Spain: Education, attitudes and native‐speakerism

AbstractSpain has traditionally featured rather low in the rankings measuring the knowledge of English by European citizens, and yet English has been constantly entering different areas of Spanish life and in all levels of education. This article delves into the efforts made at different levels of education to enable school graduates to communicate in English without difficulty. It focuses on how young people conceptualise English: their attitudes towards the language and to what extent they associate it with Inner Circle countries, or whether instead they see it as a tool for international communication. This discussion is complemented with an analysis of the pervasiveness of ‘native‐speakerism’ in Spanish society, which we claim acts as another handicap to the normalisation of the use of English as a lingua franca by Spanish citizens in multicultural settings within and outside the country.

Inter-laboratory comparison of routine autoantibody detection methods for autoimmune neuropathies and myasthenia gravis.

Serological tests are important to detect autoantibodies (autoAbs) in patients with autoimmune neuropathies (AN) and myasthenia gravis (MG) as they are biomarkers for diagnosis, stratification, treatment selection, and monitoring. However, tests to detect autoAbs frequently lack proper standardization and results differ across diagnostic laboratories. We compared results for tests routinely performed in Spanish diagnostic laboratories to detect AN and MG autoAbs. In the Spanish Society of Immunology Autoimmunity Group national workshop, serum samples from 13 patients with AN or MG were tested for anti-ganglioside, anti-myelin-associated glycoprotein (MAG), anti-nicotinic acetylcholine receptor (AChR), and anti-muscle-specific kinase (MuSK) autoAbs using reference methods and were distributed for analysis to 27 participating laboratories using their routine methods. Overserved were inter-laboratory variability and worryingly low sensitivity, especially for anti-ganglioside immunoglobulin G and anti-MAG autoAb detection. This pilot study reflects autoAbs detection state of the art in AN and MG testing in leading diagnostic laboratories in Spain, highlighting the need for standardization prior to clinical use.

Schizoaffective Disorder and Parkinson’s Disease: a case report

IntroductionWe present the case of a patient with schizoaffective disorder and Parkinson’s disease (PD), requiring treatment adjustment, with the use of high doses of quetiapine for the treatment of psychotic symptomatology.ObjectivesThe aim is to briefly review the treatment of dopaminergic psychosis in the elderly.Methods Patient aged 86 years, institutionalised, presenting severe episodes of behavioural alteration, high anxiety and delusions of harm, together with auditory and visual hallucinations. As relevant physical history, the patient has AHT, aortic insufficiency, and bladder cancer operated on in 2012. As psychiatric history of interest, the patient has been diagnosed since his 30s with schizoaffective disorder, Parkinson’s disease and moderate-severe cognitive impairment secondary to the previous two.As usual treatment, in addition to anticoagulation and antihypertensive therapy, the patient has been receiving L-dopa for his PD for years, antidepressant treatment with escitalopram 10mg, haloperidol 80 drops a day, divided into three doses, and lormetazepam 2mg as a hypnotic.In addition to the symptoms described above, the patient had episodes of confusional features, as well as marked stiffness in the cogwheel and significant gait disturbance, having suffered several falls without serious repercussions.Results Due to the comorbid neurological pathology, it was decided to progressively modify the treatment, withdrawing the benzodiazepine due to the risk of confusional disorder and replacing it with trazodone. Antipsychotic treatment was gradually replaced by extended-release quetiapine, reaching a maximum dose of 800mg. Likewise, escitalopram treatment is replaced by sertraline.With this adjustment, there was an improvement in the psychotic symptoms, as well as in the anxious symptoms. Episodes of distress are NOT observed, and the patient’s functionality improves, allowing him/her to participate in daily activities, both cognitive stimulation and physiotherapy.ConclusionsThe Spanish Society of Psychogeriatrics recommends that before using antipsychotics, it is advisable to first treat the underlying potentially treatable causes (pain, infections, toxic effects of drugs…), assess non-pharmacological interventions and always, if the use of antipsychotics is required, assess the risk-benefit ratio.In relation to the above, it is not surprising that in the elderly, the use of second-generation antipsychotics is recommended in the first place, as opposed to the classical ones. The latter are only recommended in emergency situations where an almost immediate effect is required.For dopaminergic psychosis, there are only controlled trials with clozapine. However, due to prescribing difficulties, aripiprazole or quetiapine is recommended in the first instance.Disclosure of InterestNone Declared

WITHDRAWN: Consensus on lipoprotein(a) of the Spanish Society of Arteriosclerosis. Literature review and recommendations for clinical practice

The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (PCSK9i) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only PCSK9i (limited for use because of its cost) significantly reduces Lp(a).However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).

Cardiovascular considerations on recreational scuba diving. SEC-Clinical Cardiology Association/SEC-Working Group on Sports Cardiology consensus document

The practice of recreational scuba diving has increased worldwide, with millions of people taking part each year. The aquatic environment is a hostile setting that requires human physiology to adapt by undergoing a series of changes that stress the body. Therefore, physical fitness and control of cardiovascular risk factors are essential for practicing this sport. Medical assessment is not mandatory before participating in this sport and is only required when recommended by a health questionnaire designed for this purpose. However, due to the significance of cardiovascular disease, cardiology consultations are becoming more frequent. The aim of the present consensus document is to describe the cardiovascular physiological changes that occur during diving, focusing on related cardiovascular diseases, their management, and follow-up recommendations. The assessment and follow-up of individuals who practice diving with previous cardiovascular disease are also discussed. This document, endorsed by the Clinical Cardiology Association of the Spanish Society of Cardiology (SEC) and the SEC Working Group on Sports Cardiology of the Association of Preventive Cardiology, aims to assist both cardiologists in evaluating patients, as well as other specialists responsible for assessing individuals’ fitness for diving practice.

SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort

ObjectiveTo develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a...

Cirugía cardiovascular y cardiología, situación actual en España de las dos especialidades hermanas: el estudio CARDIOXCARDIO

In recent years, there has been a notable shift in cardiovascular clinical practice within cardiology and surgery. The CARDIOXCARDIO study aimed to identify professionals’ opinions on working practices and relations between specialties. A survey was simultaneously sent to the 4442 members of the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) and the Spanish Society of Cardiology (SEC), yielding 385 valid responses. More than half (59%) of respondents were men, mostly specialists (7.3% residents), and 74.8% worked in the field of cardiology, predominantly in public centers (88.3%). Using a Likert scale ranging from 1 to 5 (worst to best), respondents rated relations between surgery and cardiology with an average of 3.57±0.9 points. Cardiologists rated surgeons with a mean score of 3.83±0.8, while surgeons gave cardiologists a mean score of 3,92±0.72. In addition, respondents provided numerous suggestions for improvement, which are discussed in detail, highlighting certain discrepancies in criteria between specialties. Implementing strategies based on the suggestions of professionals, together with a proactive approach to continuous improvement, could substantially enhance the quality of cardiovascular care in Spain.

Spanish registry of hemoglobinopathies and rare anemias (REHem-AR): demographics, complications, and management of patients with β-thalassemia

IntroductionThe increase in the number of patients with hemoglobinopathies in Europe in recent decades highlights the need for more detailed epidemiological information in Spain. To fulfil this need, the Spanish Society of Pediatric Hematology and Oncology (SEHOP) sponsored the creation of a national registry of hemoglobinopathies known as REHem-AR (Spanish Registry of Hemoglobinopathies and Rare Anemias). Data from the transfusion-dependent (TDT) and non–transfusion-dependent (NTDT) β-thalassemia cohorts are described and analyzed.MethodsWe performed an observational, multicenter, and ambispective study, which included patients of any age with TDT and NTDT, registered up to December 31, 2021.ResultsAmong the 1741 patients included, 168 cases of thalassemia were identified (103 TDT and 65 NTDT-patients). Survival at 18 years was 93% for TDT and 100% for NTDT. Regarding management, 80 patients with TDT (77.7%) and 23 patients with NTDT (35.4%) started chelation treatment during follow-up, with deferasirox being the most widely used. A total of 76 patients within the TDT cohort presented at least 1 complication (73.8%), the most frequent being hemosiderosis and osteopenia-osteoporosis. Comparison of both cohorts revealed significant differences in the diagnosis of hepatic hemosiderosis (p = 0.00024), although these were not observed in the case of cardiac iron overload (p = 0.27).DiscussionOur registry enabled us to describe the management of β thalassemia in Spain and to analyze the morbidity and mortality of the cohorts of patients with TDT and NTDT. Complications related to iron overload in TDT and NTDT account for most of the morbidity and mortality of the disease, which is associated with a considerable social, psychological, and economic impact, although cardiac, osteopathy and endocrinological complications requiring more attention. The convenience and simplicity of online registries make it possible to homogenize variables and periodically update data, thus providing valuable information on these diseases.

Prophylactic Antibiotics before Gynecologic Surgery: A Comprehensive Review of Guidelines.

Surgical site infections (SSIs) refer to infections in the incision, organ, or postoperative space. As common healthcare-associated infections, SSIs correlate with prolonged hospital stay, additional procedures, ICU stay, and higher mortality rates. Around 8-10% of gynecologic surgery patients may experience infectious complications, influenced by microbial contamination, surgical nature, and patient factors. The goal of this narrative review is to compare and merge recommendations from globally published guidelines concerning the utilization of antibiotics in the perioperative phase. A comparative descriptive/narrative review of the guidelines issued by the American College of Obstetrics and Gynecology (ACOG), Society of Obstetricians and Gynecologists of Canada (SOGC), Royal College of Obstetricians and Gynecologists (RCOG), National Institute for Health and Care Excellence (NICE), Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG), European Society of Gynecologic Oncology (ESGO), Société Française d' Anésthesie et de Réanimation (SFAR), Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and Hellenic Society of Obstetrics and Gynecology (HSOG) was conducted. For hysterectomy, first/second-generation cephalosporins are suggested, with metronidazole as an option. Laparoscopy without entering the bowel or vagina typically does not require prophylaxis. Uterine evacuation and hysteroscopy may involve doxycycline or azithromycin based on risk factors, whereas, for vulvectomy, cefazolin is recommended. Urogynecology procedures may include cefazolin with metronidazole. In cases of penicillin allergy, cephalosporins are suggested, and, for obese patients, adjusted doses are advised. Additional doses may be needed for prolonged procedures or excessive blood loss. Timing recommendations are 15-60 min before incision, adjusting for specific antibiotics. Clear indications exist for certain surgeries like hysterectomy, termination of pregnancy, and urogynecologic procedures. Conversely, procedures such as intrauterine device insertion, hysteroscopy, and laparoscopy typically do not necessitate antibiotic prophylaxis. For several other procedures, the evidence is inconclusive, while considering dose, timing, and indications can mitigate infectious complications and provide benefits for the healthcare system.

Encuesta sobre la actividad de los laboratorios de función pulmonar. Efectos durante la pandemia por SARS-CoV-2

IntroductionFollowing the SARS-CoV-2 pandemic in March 2020, pulmonary function testing (PFT) laboratories underwent a transformation, with a reduction in the number of tests or closure in some cases. The aim of this work was to know the activity of PFT in Spain and the modification of this activity due to the pandemic. Material and methodsA protocolised survey was carried out to members of the PFT laboratories through the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). ResultsThirty-nine hospitals in Spain responded. The pulmonary function tests most frequently performed in the PFT laboratories were forced spirometry with bronchodilator test (100%), body plethysmography (97.4%), CO transfer capacity (97.4%), respiratory muscle strength measured in the mouth (97.4%), 6-minute walking test (94.7%), measurement of exhaled fraction of nitric oxide (92.3%) and incremental exercise test (71.8%).The pandemic led to a significant decrease in the number of tests (35.4%) during 2020 with subsequent recovery in 2021, without reaching pre-pandemic values.The most important changes were increased examination times, working with personal protective equipment and ventilation of the rooms. The performance of the nasopharyngeal swab for SARS-CoV2 testing prior to the tests was not homogeneous in the PFT laboratories. ConclusionsMost hospitals are sufficiently equipped to perform the most common pulmonary function tests. The pandemic resulted in a loss of activity in all hospitals.

Dunking bizcochos: Sociability and the Material Culture of Chocolate in Eighteenth-Century Spain

ABSTRACT This article examines the social practices and material culture surrounding the consumption of chocolate in eighteenth-century Spain, through the practice of dipping bizcochos (sponge biscuits). Yet dipping biscuits into chocolate appears ubiquitously in early modern textual and visual sources, this custom has been mostly overlooked by historians. By focusing on the materiality of chocolate consumption, this study offers another example of a more complicated and nuanced story of ‘the civilising process’ and manners in the eighteenth century. An examination of underexplored visual, textual and material evidence allows us to further our understanding of how the introduction of chocolate had a profound impact on Spanish economies, culture and society. Overall, the focus on bizcochos (and dipping) opens a window to explore broader cultural phenomena regarding sociability, table manners, and gender relations in the Spanish Enlightenment.