Spanish Society Research Articles

Variations in the treatment of acute peripheral facial paralysis. A nationwide survey

BackgroundAcute peripheral facial paralysis may be diagnosed and treated by different specialists. ObjectiveThe aim of this study was to explore the variability in the treatment of Bell’s palsy (BP) and Ramsay Hunt Syndrome (RHS) among different medical specialties. MethodsAn anonymous nationwide online survey was distributed among the Spanish Societies of Otorhinolaryngology (ORL), Neurology (NRL) and Family and Community Medicine (GP). Results1039 responses were obtained. 98% agreed on using corticosteroids, ORL using higher doses than NRL and GP. Among all, only 13% prescribed antivirals in BP routinely, while 31% prescribed them occasionally. The percentage of specialists not using antivirals for RHS was 5% of ORL, 11% of NRL, and 23% of GP (GP vs. NRL p = 0.001; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0,002). 99% recommended eye care. Exercises as chewing gum or blowing balloons were prescribed by 45% of the participants with statistically significant differences among the three specialties (GP vs. NRL p = 0.021; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0.002). ConclusionThere is general agreement in the use of corticosteroids and recommending eye care as part of the treatment of acute peripheral facial paralysis. Yet, there are discrepancies in corticosteroids dosage, use of antivirals and recommendation of facial exercises among specialties.

«Крестовый поход» против французов: участие духовенства в испанской герилье 1808–1814 гг.

After the severe suppression of the uprising in Madrid by the French and the abdication of Charles IV and Ferdinand VII from the Spanish throne in May 1808 a long military conflict began, which in Spanish historiography was called the War of Spanish Independence. The Catholic Church played a significant role in mobilizing the Spanish population in the face of the French invasion. Most of the clergy and monks became those representatives of the educated strata of the country’s population who did not support the plans of Napoleon and his protege, Jose I, to secularize and reform Spanish society in accordance with French ideals. Priests spoke from the pulpits of churches and cathedrals with addresses and sermons calling for a fight against the «Antichrist» Napoleon and his army, and abbots of monasteries inspired monks and novitiates to fight against the invaders with weapons in hand. Moreover, the clergy managed to justify the direct participation of the clergy in such a «crusade» against Napoleon's army, which led to the formation of «crusaders-guerrilleros», which participated in the guerrilla war against the French army on an equal basis with other Spanish guerrilleros. Representatives of monastic orders, Capuchins, Carmelites and Franciscans, who suffered most from the religious reforms of Jose I, which implied, in particular, the liquidation of monasteries and monastic and mendicant orders on the territory of the Iberian Peninsula, were especially actively involved in the Spanish guerrilla war. It was the church that became an element of unity for the Spanish population in the face of the French invasion, providing the rebels with an ideological justification for their mission to liberate Spain.

The cosmopolitan idea in Spanish Krausism and its influence on the progress of Spanish society

Este trabajo se centra en la indagación histórica del cosmopolitismo en el pensamiento decimonónico español de origen krausista como precursor en nuestro país de la idea de ciudadanía global y gobernanza cosmopolita. Hay que decir que el pensamiento krausista español de finales del siglo XIX resultó crucial en el desarrollo de las ciencias sociales de nuestro país, interesándose por el derecho, la sociología, la psicología, la ciencia política y, sobre todo, la educación, al tiempo que también fue decisivo en la emergencia del primer feminismo español. El objetivo de este trabajo, por tanto, no ha sido otro que mostrar la importancia del hispanismo krausista en el desarrollo del cosmopolitismo, elucidando el alcance de su influencia en los más variados ámbitos de la vida de la época, lo que le confiere especificidad y una relevancia singular desde un punto de vista crítico e historiográfico. Los krausistas creían en una humanidad unificada, la educación integral y humanista y la participación ciudadana. Abogaban por una sociedad equitativa y justa, la descentralización del poder y la colaboración entre naciones. También promovían la tolerancia religiosa y el diálogo intercultural.

XXVIII Sespo Congress (Spanish Society of Epidemiology And Oral Public Health) Valencia, Spain.: 10-11 November 2023.

XXVIII Sespo Congress (Spanish Society of Epidemiology And Oral Public Health) Valencia, Spain.: 10-11 November 2023.

Taurolidine lock in pediatric patients with intestinal failure. A practical guideline from the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP)

Objectives: the prevention of central line-associated bloodstream infections is a critical aspect of care for patients with intestinal failure who are treated with parenteral nutrition. The use of taurolidine in this context is becoming increasingly popular, however there is a lack of standardization in its pediatric application. The objective of this work is to develop a guide to support its prescription. Methodology: the guide is based on a review of the literature and expert opinions from the Intestinal Failure Group of the SEGHNP. It was developed through a survey distributed to all its members, addressing aspects of usual practice with this lock solution. Results: this manuscript presents general recommendations concerning taurolidine indications, commercial presentations, appropriate forms of administration, use in special situations, adverse reactions, and contraindications in the pediatric population Conclusions: taurolidine is emerging as the primary lock solution used to prevent central line-associated bloodstream infections, proving to be safe and effective. This guide aims to optimize and standardize its use in pediatrics.

2024 Position Statement on Dietary Guidelines by SEEDO (Spanish Society for the Study of Obesity)

2024 Position Statement on Dietary Guidelines by SEEDO (Spanish Society for the Study of Obesity)

Beyond lines of treatment: embracing early high-efficacy disease-modifying treatments for multiple sclerosis management.

Recent advances in multiple sclerosis (MS) management have shifted perspectives on treatment strategies, advocating for the early initiation of high-efficacy disease-modifying therapies (heDMTs). This perspective review discusses the rationale, benefits, and challenges associated with early heDMT initiation, reflecting on the obsolescence of the traditional "first-line" and "second-line" treatment classifications. The article emerges from the last update of the consensus document of the Spanish Society of Neurology on the treatment of MS. During its development, there was a recognized need to further discuss the concept of treatment lines and the early use of heDMTs. Evidence from randomized controlled trials and real-world studies suggests that early heDMT initiation leads to improved clinical outcomes, including reduced relapse rates, slowed disease progression, and decreased radiological activity, especially in younger patients or those in early disease stages. Despite the historical belief that heDMTs involve more risks and adverse events compared to moderate-efficacy DMTs (meDMTs), some studies have reported comparable safety profiles between early heDMTs and meDMTs, though long-term safety data are still lacking. The review also addresses the need for a personalized approach based on patient characteristics, prognostic factors, and preferences, explores the importance of therapeutic inertia, and highlights the evolving landscape of international and national guidelines that increasingly advocate for early intensive treatment approaches. The article also addresses the challenges of ensuring access to these therapies and the importance of further research to establish long-term safety and effectiveness of DMTs in MS.

Postoperative management of varicose vein surgery: recommendations of the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Chapter of Phlebology and Lymphology (CEFyL)

Postoperative management of varicose vein surgery: recommendations of the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Chapter of Phlebology and Lymphology (CEFyL)

Clinical practice guideline of the Spanish society of oral surgery for dental care in patients with oral cancer.

Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortality rate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity is broad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding an increase in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, and improving the efficacy of the treatment itself. A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncology of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with the University of Valencia, University of Barcelona, and University of the Basque Country, developed this Clinical Practice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical questions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. The systematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre for Reviews and Dissemination). The recommendations were prepared based on the GRADE methodology. Various recommendations were defined, derived from the 21 PICO questions, referring to prevention, treatment and care for alterations arising from the pathology of oral cancer itself and its treatment. The preparation of this clinical practice guideline allows recommendations to be generated based on the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncological treatment, which may be of use to the multidisciplinary team treating this type of patient.

Current landscape of gastrointestinal radiation oncology in Spain: a multicenter real-life survey and comparison with key clinical guidelines.

The GI Tumors Workgroup, a division of the Spanish Society of Radiation Therapy, conducted a survey in December 2020 to assess the adherence of radiation oncologists in Spain to international guidelines for gastrointestinal tumors. Using Google Forms, we designed a survey covering treatments for esophageal, gastric, pancreatic, and rectal cancers. In esophageal cancer treatment, neoadjuvant chemoradiation was the standard in 76.7% of institutions. Radiation doses range from 41.1 to 50.4 Gy in conventional fractionation. Planning positron emission tomography-computed tomography (PET-CT) was performed in 83.3% of centers, and intensity-modulated radiation therapy/volumetric-arc radiation therapy (IMRT/VMAT) was the preferred technique in 86.7% of institutions. For gastric cancer, 71.4% followed perioperative chemotherapy guidelines. In the case of adjuvant radiotherapy, the majority prescribed 45-50.4 Gy, and 82.1% used IMRT/VMAT for treatment. For pancreas cancer, neoadjuvant chemotherapy followed by surgery in borderline resectable tumors and induction chemotherapy followed by radical radiotherapy for non-resectable tumors were the most frequent approaches. IMRT/VMAT was the primary technique. Locally advanced rectal cancer treatment is mainly based on neoadjuvant radiotherapy in all institutions. The preferred radiation doses typically range from 45 to 50 Gy in conventional fractionation. IMRT/VMAT was standard in most Institutions. Spain's radiotherapy practices among respondents generally align with international guidelines for GI tumors highlighting Spain's commitment to evidence-based medical practice.

Consideraciones cardiovasculares para la práctica de buceo recreativo con escafandra autónoma. Documento de consenso de SEC-Asociación de Cardiología Clínica/SEC-GT Cardiología del Deporte

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.

Varicose vein surgery in elderly patient, an update. The Spanish Chapter of Phlebology and Lymphology and the Spanish Society of Angiology and Vascular Surgery

Varicose vein surgery in elderly patient, an update. The Spanish Chapter of Phlebology and Lymphology and the Spanish Society of Angiology and Vascular Surgery

Registry of activities of the Spanish Society of Angiology and Vascular Surgery, year 2019

Registry of activities of the Spanish Society of Angiology and Vascular Surgery, year 2019

Influencia de la concentración de triglicéridos en la lipoproteína(a) en función de la dislipidemia

BackgroundRecently, an inverse relationship between the blood concentration of lipoprotein(a) (Lp(a)) and triglycerides (TG) has been demonstrated. The larger the VLDL particle size, the greater the presence of VLDL rich in apoliprotein E and in subjects with the apoE2/E2 genotype, the lower Lp(a) concentration. The mechanism of this inverse association is unknown. The objective of this analysis was to evaluate the Lp(a)–TG association in patients treated at the lipid units included in the registry of the Spanish Society of Atherosclerosis (SEA) by comparing the different dyslipidemias. Patients and methodsFive thousand two hundred and seventy-five subjects ≥18 years of age registered in the registry before March 31, 2023, with Lp(a) concentration data and complete lipid profile information without treatment were included. ResultsThe mean age was 53.0 ± 14.0 years, with 48% women. The 9.5% of subjects (n = 502) had diabetes and the 22.4% (n = 1184) were obese. The median TG level was 130 mg/dL (IQR 88.0–210) and Lp(a) 55.0 nmol/L (IQR 17.9–156). Lp(a) concentration showed a negative association with TG concentration when TG values exceeded 300 mg/dL. Subjects with TG > 1000 mg/dL showed the lowest level of Lp(a), 17.9 nmol/L, and subjects with TG < 300 mg/dL had a mean Lp(a) concentration of 60.1 nmol/L. In subjects without diabetes or obesity, the inverse association of Lp(a)–TG was especially important (p < 0.001). The median Lp(a) was 58.3 nmol/L in those with TG < 300 mg/dL and 22.0 nmol/L if TG > 1000 mg/dL. No association was found between TG and Lp(a) in subjects with diabetes and obesity, nor in subjects with familial hypercholesterolemia. In subjects with multifactorial combined hyperlipemia with TG < 300 mg/dL, Lp(a) was 64.6 nmol/L; in the range of 300–399 mg/dL of TG, Lp(a) decreased to 38. 8 nmol/L, and up to 22.3 nmol/L when TG > 1000 mg/dL. ConclusionsOur results show an inverse Lp(a)–TG relationship in TG concentrations > 300 mg/dL in subjects without diabetes, obesity and without familial hypercholesterolemia. Our results suggest that, in those hypertriglyceridemias due to hepatic overproduction of VLDL, the formation of Lp(a) is reduced, unlike those in which the peripheral catabolism of TG-rich lipoproteins is reduced.

Analisis de la evolución de la atención farmacéutica al paciente externo en los servicios de farmacia hospitalaria en España tras la puesta en marcha y desarrollo de la iniciativa MAPEX

Introduction and objectiveIn 2015, the Spanish Society of Hospital Pharmacy (SEFH) launched the Strategic Map for Outpatient Pharmaceutical Care (MAPEX), with the purpose of adapting the activity offered in Hospital Pharmacy outpatient clinics to the new healthcare context.The aim of the present study was to analyse the evolution of outpatient pharmaceutical care in Hospital Pharmacy Services in Spain in the period 2016-2021 after the implementation and development of the MAPEX initiative. Material and methodThe implementation and development of the project was carried out by a group of experts from SEFH and consisted of five phases: creation of the structure, consensus conference, situation analysis, development of strategic initiatives and evolutionary analysis.To analyse the evolutionary development, a specific 43-item questionnaire was developed that addressed aspects related to structure, context, integration, processes, outcomes and research and was answered in 2016 and 2021 (in the latter case by adding 3 additional questions). Results141 hospitals participated in the status survey in 2016 and 138 in 2021. Significant differences were found in all dimensions analysed. None of the aspects assessed suffered a setback in this period.The most highly rated aspects at the general level were the improvement of the care model (65.0%) and at the local level, the incorporation of non-face-to-face pharmaceutical care (42.8%). Further progress in the coming years in the expansion and practical application of the methodology proposed in the project was considered a priority. ConclusionsThe implementation and development of the MAPEX initiative has had a positive impact in terms of quality of care for outpatient pharmaceutical care in Hospital Pharmacy services in Spain.

Paradoxographical Descriptions of Caribbean Animals in Fray Ramón Pané's Relación acerca de las antiguëdades de los Indios

This essay investigates Fray Ramón Pané’s text from 1500 CE, Relación acerca de las antiguëdades de los Indios, within the literary context of the paradoxography. It examines cultural frameworks and general literary knowledge that would have been understood by Pané within the structures of Spanish and Hieronymite societies. This essay compares the framework and content of Pané’s work with the known paradoxographies of Aelian and Aristotle, focusing on the emphasis placed by Pané on transformation via linguistic translation/interpretation and mythological animal representation. Through my analysis of the original text, I outline Pané’s transliteration of Taino mythology and culture, emphasizing the significance of this New World text itself within the paradoxographical genre, a genre that had generally been in disuse long before Europeans arrived in the Caribbean. While I base my analysis in the study of genre, my general focus is the inclusion and importance of transformation and animal lore within Taino culture, and their transliteration into a little-used European genre by a little-known Spanish friar.

When Was the War in Spain? Liberal State, Illiberal Justice in the Twentieth Century

The article analyzes increasingly militarized state power and public order in twentieth-century Spain, discussing these in the context of other European states’ disciplinary regimes, with their ubiquitous social-Darwinist dimension in an era of accelerating urbanization, industrial change and emergent mass societies. The article offers a dissection of the often problematically opaque term ‘liberal’, arguing that wherever Spain or other twentieth-century European states were positioned on the dictatorial-through-parliamentary-constitutional spectrum, they all came to be ‘gardening states’ (Bauman). Each state's goal was to sculpt its population as part of a nationalist project – nationalism being the norm, whether named as such or not. Francoism is analysed in this framework, as a hybrid war-born political order blending old-style, top-down military control with new forms of populist mass mobilization from below, the latter enabled and accelerated by the war of 1936–1939. The article defines the Franco dictatorship as fascist in the 1940s and totalitarian for far longer, until macro-economic changes – which its cupola believed for a long time need not affect the deep form of Spanish society – hollowed out Francoism's own ideological categories (and its ‘disciplinary’ efficacy), but not its obsession with social control, which it called ‘social peace’.

Study and analysis of Hate Crimes in Spain (2013-2020)

Introduction: In this article, we analyze the evolution of hate crimes in Spain from 2013 to 2020. Hate crimes are based on the relationship between racism and fear, shaped by a social and economic rejection based on race-ethnic identity, religion, sexual orientation-identity, sex/gender, and social class. Method: These crimes are examined by type and population affected with the figures obtained from the reports of the Ministry of the Interior of the Report on the Evolution of hate crimes. The methodology used has been a critical documental analysis of sources and data to reveal an X-ray of hate crimes within Spanish society and in comparison, to the European Union. The typology of the crimes is identified and analyzed. Results: The results indicate an overall increase in such crimes, particularly in five autonomous communities, with a significant increase in crimes motivated by sexual orientation and identity. Moreover, the data shows a significant increase in certain crimes related to the COVID-19 pandemic. Conclusions: Further training for law and health officials is required to improve the precision of the registry, cataloguing and data generation in order to identify trends. In addition, pedagogy for the general population is necessary to create awareness of these crimes to the public.

Translated article] Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by Regions in Spain

ObjectiveTo analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between 2016 and 2021. MethodsA committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching, and investigation. It was carried out in 2 periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. Results141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialisation of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). ConclusionsThe implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement, as well as those areas to be developed through strengthening and corrective actions. The expansion of the project in the coming years will mean progress toward excellence in care and in the improvement of health results.

Breaking the cycle of couscous pedagogy: Are future teachers empowered to teach in multicultural societies?

ABSTRACT Despite the increasing racial diversity within British and Spanish societies, teacher education and school curricula continue to be Eurocentric and taught by predominantly White teachers. This quantitative research sought to explore the perceptions of student teachers in relation to their attitudes and preparedness to teach in ethnically diverse school contexts. Data were gathered at two universities, one in Southern Spain and the other in Northwest England. The article employs critical race theory and critical whiteness studies as frames to understand outcomes of an online questionnaire. The majority White student teacher sample across both countries register an acceptance of racial diversity and report the need for better preservice teacher education in this respect. Despite preservice teachers’ positive responses to racial diversity, teacher education in both countries fails to equip them for increasingly diverse classrooms. This failure serves to replicate the enactment of whiteness and, does not develop student teachers’ stated commitment to racial diversity.