Nº 9April 2007

The Journal of the Fundación Jiménez Díaz

�� The 2nd International Meeting on Translational Research andIndividualized Medicine: New Treatment Applications�� Assisted Reproduction Unit

SPECIAL ANNIVERSARY ISSUE

72nd

Anniversary

Instituto de Investigaciones Clínicas y Médicas

52nd

AnniversaryClínica de la Concepción

www.capiosanidad.es

Fundación Jiménez Díaz - Capio Magazine Avda. Reyes Católicos, 2 - 28040 Madrid

Coordination and production: Capio-Sanidad Marketing Department Editing and design: Ibáñez & Plaza Asociados S.L. - Bravo Murillo, 81 (4º C) - 28003 Madrid - Spain

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ISIS

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3. FJD NEWS

72nd AnniversaryCelebration 1 Certifi-cates of Honor Awar-ded � 3rd FJD Doc-toral Thesis Awards �

On-line � 1st Practi-cal Training Courseon Tropical Patho-logy in Madrid andEthiopia � Our Pro-fessionals � 2nd FJDBiomedicine Semi-nars � Update Cour-se in Ophthalmologyfor Occupational

Physicians � Fire Sa-fety Plan: Work inProgress!

9. NURSING TheCommit-tee forthe Ad-vance-ment ofNursingInvestiga-tion GetsRolling

10. INVESTIGA-TION The 2nd In-ternational Meeting

on Translational Re-search and Individua-lized Medicine

11. TEACHING

Remembering Pro-fessor Manuel deOya

12. OUR SPE-CIALISTS Assis-ted ReproductionUnit � Celiac Disea-se: Gluten? No,

Thanks � COPD canbe Prevented and Tre-ated. Smoking or He-alth: Your Choose �Nosocomial Infec-tions: Did you Washyour Hands?

15. CAPIONEWS New CapioClinic in Talavera dela Reina (Toledo) �

Handling Samples �Capio Hospital SurPaper Presentation:

“Cardiac Rehabilita-tion: Latest Advancesin Stem-Cell Rese-arch for Cardiac Pa-thologies" � CapioRecoletas AlbaceteNeurology ServiceRecognized for itsWork � New Me-mory Unit in the Ca-pio Hospital TresCulturas

This issue of imPUL-SO-the publication'sninth installment-of-

fers readers an in-depth ac-count of our anniversary cele-bration.

Itake great satisfaction andpride in celebrating the72nd anniversary of the

Fundación Jiménez Diaz andthe 52nd anniversary of theClínica; however, it is evenmore fulfilling to see how thework and effort put in by allthe FJD professionals this pastyear has produced the fine re-sults found in our recently pu-blished Annual Report.

This demonstrates theextent to which we ha-ve made good on our

health-care commitment interms of volume, quality ofcare, and wait-time goals.Results like these allow us toguarantee health care to allthe citizens assigned to ourcenter as well as those withinour area of influence.

This same work and ef-fort by Fundación Ji-ménez Díaz professio-

nals is also the source whichfeeds each issue of imPUL-SO, making it possible for usto include in each new install-ment more news on courses,new additions to our team,conferences, work groups,and reports from our specia-lists.

It is now time for us tocontinue looking optimis-tically toward what lies

ahead. Our project is beco-ming more and more of a re-ality, and consolidating thefuture of the FJD is in thehands of all its professionalswho know the past and livethe present.

In the words of Lucía Mar-tín Moreno that resoun-ded throughout the main

lecture hall during her speechas representative of the pro-fessionals honored for com-pleting 25 years of work inthe Fundación, "...our suc-cess and our ability to attractpeople in need of care as wellas those who down the roadmay look to train in and then

become part of our projectwill be determined by theway we work, the zeal withwhich we do it, the examplewe set, and the way in whichwe understand our surroun-dings.”

In closing, on behalf of theFundación management, Iwould like to thank all the

different professional groupswho make up our communityfor your effort; we have nodoubt that together, we willcontinue building the future.

Juan Antonio Álvarode la Parra

FJD Manager

From the Hospital Manager

Abril 2007 ImPULSO

On February 14th, the Fundación Jimé-nez Díaz celebrated its 72nd Anniver-sary. Following the mass held in the

chapel to begin the commemorative events, aclinical-pathological paper entitled "HIV-Posi-tive Argentine Patient with Fever and Lung In-filtrates" was presented to an audience in themain lecture hall by Dr. Manuel FernándezGuerrero, head of the Internal Medicine Servi-ce and Dr. José Forte Alen, of the PathologicalAnatomy Service.

Following the presentation, FJD professio-nals gathered in the main lecture hall for themost personally significant of all the anniver-sary celebration events: the awarding of theCertificates of Honor to personnel completingtwenty-five years of work in the Fundación. Inhis address to the ceremony attendees, the Ma-naging Director of the FJD, Juan Antonio Ál-varo de la Parra, expressed his gratitude onceagain to the professionals for their efforts andencouraged them to continue building the ins-titution's future.

Mr. Álvaro gave a brief overview of the hos-pital's work in 2006 in the three areas of care, te-aching, and investigation, drawing special atten-tion to the Fundación's fulfillment of its commit-ments to the public health-care system. “We havemade good on our commitment to health care interms of volume, quality of care, and wait-timegoals. Such results allow us to guarantee healthcare for all the citizens assigned to our center andthose within our area of influence.”

At the same time, Mr. Álvaro pointed outthe achievements made in inves-tigation and in teaching; he madespecial note of the investment ef-forts being made to continue re-novating the FJD's facilities.

After the Certificates of Ho-nor were handed out, Dr. LucíaMartín Moreno took the floor inrepresentation of all those whohad been recognized. An Asso-ciate Head of the DermatologyService, Dr. Martín Moreno ex-pressed the recipients' gratitudefor the distinction.

INVESTIGATION AWARDS

Next on the schedule ofevents, Dr. Joaquín Arenas Bar-bero, Assistant General Director

for Research and Research Assessment at theInstituto de Salud Carlos III, took the floorfor the 3rd FJD Clinical and ExperimentalBiomedical Investigation Awards Ceremony(see page 5).

Professor Julio R. Villanueva, President ofthe FJD Board of Governors, brought theproceedings to a close with words of encou-ragement for the Fundación professionals,encouraging them to stay the course and con-tinue along the lines set out more than se-venty years ago by Professor Carlos JiménezDíaz, whose work has served as a model forthe current health-care system. Dr. Villanue-

va highlighted for those in attendance thatthe institution's future is in the hands of allthe people who work each day in the hospi-tal, which makes their responsibility andtheir exemplary work crucial to the successof the institution.

The event closed with a group rendition ofthe traditional song “Salve Rociera.” In theevening, the celebration culminated with agala dinner at the Casino on Calle Alcalá,thus putting the final touch on the 72nd an-niversary of the Instituto de InvestigacionesClínicas y Médicas and the 52nd anniversaryof the Clínica de la Concepción.

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April 2007 ImPULSO

FJD News

The Fundación Jiménez Díaz celebrates its 72nd Anniversary

Presiding over the event was Professor Julio R. Villanueva, President of the FJD Board of Governors (Right: duringhis speech). Accompanying him at the presidential table were Juan Antonio de la Parra, the Managing Director ofthe FJD; Juan Carlos González, Capio Sanidad Corporate Director; Luis Javier García, Capio Sanidad General Di-rector; and Dr. Luis Guinea Esquerdo, the Medical Director of the FJD.

The Fundación's Managing Director during his speech in the main lecture hall.

SPECIAL ANNIVERSARY ISSUE

ESPECIAL ANIVERSARIO

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April 2007 ImPULSO

In keeping with tradition, warm ap-plause thundered through the mainlecture hall during the awards cere-

mony for the Certificates of Honor in re-cognition of Fundación employees whohave worked in the center for 25 years.This year, Dr. Lucía Martín Moreno, anAssistant Head of Dermatology (appea-ring above), had the honor of addressingthose in attendance on behalf of the reci-pients. Photographs depicting some ofthose who received their certificates canbe seen on this page. The complete listsof professionals who received certifica-tes is as follows:Manuel Caro Antón Lorenzo Serrano CarboneroCarlos de Prado Carreras Luis Ortega Alba María Luisa Becedas García Rafael Bragado Herrero Lucía Martín Moreno Adela Rovira Loscos Aurora Marín Escrich María Gloria Barrera Viller Julia Fernández Serrano Dolores Navajos Romero María Carmen Mancebo SerranoManuela Gómez López Esperanza Vélez Vélez Elena Aguado FrescoJesús Ceto DelgadoÁngel Luis Aparicio Perez Teresa Gómez Roldán We congratulate you all.

Certificates ofHonor Awarded

ESPECIAL ANIVERSARIO

The awarding committee ofthe 3rd Fundación JiménezDíaz Doctoral Thesis

Awards unanimously gave the dis-tinction to the following specia-lists:

-The prize for Doctoral The-sis in Experimental Medicinewas awarded ex aequo to two win-ners: Alberto Lázaro Fernándezand Vanesa Esteban Vázquez,who both received the maximum

score on the evaluation. The twowill share the 3,000-euro prize.

-The prize for Doctoral The-sis in Clinical Medicine was al-so awarded ex aequo to two win-ners: José Morales Coraliza andRosa Riveiro Álvarez, who, liketheir counterparts in experimen-tal medicine, also both receivedperfect scores on the evaluation.They will split the 3,000-europrize.

10 applications were receivedthis year: 5 for experimental bio-medicine and 5 for clinical biome-dicine. Each application was sub-mitted for impartial review bymembers of the committee. Oncethe evaluations and scores werereceived for all the applications,the awarding committee-made upof Dr. Luis Guinea Esquerdo, Dr.Carmen Ayuso García, Dr. Victo-ria del Pozo Abejón, and Dr. Igna-cio Gadea Gironés-then met to re-ach a final decision.

The committee noted the re-markable quality of the projectspresented, and expressed its grati-tude for the high level of impartia-lity with which the awards were

given out.Winners in both categories

shall present a summary of theirtheses at a date to be announced.Those not receiving awards willbe given certificates in recogni-tion of their participation.

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April 2007 ImPULSO

FJD News

3rdFundación Jiménez DíazDoctoral Thesis Awards

Scenes from this year's anniversary dinner held in the Ca-sino de Madrid on the Calle Alcalá.

The four award winners posing with the FJD Managing Director, Medical Director, and Assistant Director of Research. Right: Dr. Joaquín Arenas Barbero,Assistant General Director General for Research and Research Assessment at the Instituto de Salud Carlos III, who presided over the awards ceremony.

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April 2007 ImPULSO

We in the Marketing Department would liketo thank all the FJD professionals who parti-cipated in the filming of the video for yourcooperation.Thank you for your help and your patience.Kind regards.

Fran Marin Clavero,Mari Cruz García Rueda

INTRANET�NEW INTRANET PORTAL FOR THE OCCUPATIO-NAL HEALTH AND SAFETY SERVICE

A new intranet portal has been created for theOccupational Health and Safety Service pro-viding information on all recently-updatedversions of internal emergency proceduremanuals.http://intranet/SaludLaboralyPrevencion/de-fault.aspx

�ACCESS TO THE “UP-TO-DATE" DATABASE

FOR FJD PROFESSIONALS

Now accessible via “links” on the FJD intra-net, the “Up-to-Date” database, as you allknow, is a valuable support system for diag-nosing and treating patients, and is endorsedby some of the world's most important pro-fessional societies in the medical field. The database will be given a two-month trialperiod to evaluate its use, at which time thecenter will receive a subscription proposal.

�CLINICAL PATHWAYS

A portal has been added to the FJD intranetso that all professionals may consult the exis-ting current clinical pathways.http://10.161.1.19/direccionmedica/default.aspx

WEB SITETHE FJD WEB SITE RECEIVED 24,349 VISITS IN

JANUARY

24,349 visitors entered the Fundación Jimé-nez Díaz Web site in January, accessing36,353 of its links.In December, 17,223 visited the site, viewing24,698 of its URLs. This means that the num-ber of visitors has increased by 33%.Once again, the most popular pages are theprivate-sector page and the service offeringpage. The services receiving the most visitorsare gynecology, followed by cardiology andthen orthopedics-traumatology.

Dr. Carlos Cenjor Español,Head of the Ear, Nose andThroat Service, has beenchosen to become a full pro-fessor in the university. Withthis, Dr. Cenjor Españoljoins the university Ear, No-se, and Throat Department,where he and other candida-tes will be up for tenured po-sitions. Last February, Ana Posada

Pérez was named Directorof Administration of theFundación Jiménez Díaz,thus leaving her previous po-sition as Head of the CapioSanidad Treasury Depart-ment. Ms. Posada began hercareer in our group in 1995at the Clínica Recoletas Ciu-dad Real. She has been apart of the treasury depart-ment since 2005.

NEW ADDITIONS TO THE FJD:Macarena Bonilla Porras inthe pharmacy service Gema Toledano Mayoral inthe pharmacy service

Eva Castilla Bazán in thepharmacy service Mur de Víu in the psychiatryserviceGustavo Rubio Romero inthe oncology serviceNicolino Piro Martín in theemergency roomRaquel Alfaro in the emer-gency roomCora Hernández Rodríguezin the gynecology serviceMiguel de la Fuente in theophthalmology serviceCarlos Santonja in the patho-logical anatomy serviceMar Fernández Nieto in theallergology service

Organizational video filmed

ON-LINE

Ourprofessionals

The 1st Practical TrainingCourse on Tropical Patho-logy will be held in June.The course will take place inthe Fundación Jiménez Díazand in the Gambo Hospitalin Ethiopia. The organizerrepresenting the FJD in thecourse will be Dr. Miguel deGórgolas, a specialist in In-ternal Medicine and Infec-tious Diseases who headsthe Travel Medicine Consul-tation Service. The course has been desig-ned for residents and specia-lists who work in internalmedicine, pediatrics, familymedicine, or microbiology.Its main objective is to upda-te these professionals' kno-wledge of tropical diseases-rare to our environment but

nowadays diagnosed withincreasing frequency due totwo social phenomena: thesubstantial increase in travelto tropical and sub-tropicalareas, and the growing num-ber of immigrants who cometo Spain from such coun-tries.The theory taught in thecourse will be complemen-ted by practical field workperformed in a rural Ethio-pian hospital, where studentswill visit admitted and am-bulatory patients and thephysicians who managetheir care.Both community doctorsand doctors working in hos-pitals will benefit from thetheoretical and practicalcontent of the courses.

In the first two weeks, stu-dents will take classes inMadrid on tropical patho-logy, and also participate inclinical and practical semi-nars on the microbiologicaland anatomical-pathologicalside of tropical diseases.Participants will spend thethird and fourth weeks inEthiopia taking daily clinicalsessions, practical classes,and theory.

1st Practical Training Courseon Tropical Pathology inMadrid and Ethiopia

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April 2007 ImPULSO

FJD News

Thanks to the coordina-tion efforts of Dr. Tere-sa del Campo, Head of

the Occupational Health andRisk Prevention Service ofthe Fundación Jiménez Díaz,along with Dr. Emilia Fernán-dez Navarrete, a member ofthe Spanish Association ofSpecialists in OccupationalMedicine, an update course inophthalmology for occupatio-nal physicians was held on Ja-nuary 18th in the main lecturehall of the Fundación JíménezDíaz.

The course lectures weregiven by Dr. Blanca GarcíaSandoval, Head of the Oph-thalmology Service of theFundación Jiménez Díaz,along with Dr. Ana Sanz Ló-pez, Assistant Physician at theHospital General de CiudadReal.

TOPICS ADDRESSED

The topics dealt with throug-hout the course were as fo-llows:•Treating ophthalmologicalillnesses in occupational he-alth: which to treat, when torefer patients, new treatments.•Occupationally-induced ocu-lar pathology (caused byVDU screens, ionizing radia-tion, etc.).•Refractive intervention•Ophthalmological exam forVDU screen users and con-versations on a vigilance pro-tocol for people using VDUscreens.•Attitude of the occupationalphysician toward ocular pa-thology. Vision fatigue, chan-ges in refraction. Dryness ofthe eyes. Phoria.•Protection in OccupationalOphthalmology. Visual com-fort in the work space (illumi-nation, humidity, etc.)

A team from the SpanishNational Research Coun-cil (CSIC) has discovered

that mutations in the gene enco-ding factor B (BF) lead to a highrisk of developing atypical he-molytic uremic symdrome(HUS). HUS is the leading causeof acute renal failure in children.The study, published in the latestissue of the magazine Procee-dings of the National Academy ofSciences of the United States ofAmerica, describes how the dise-ase develops and offers insight in-to the design and development oftreatment strategies.

Santiago Rodríguez de Córdo-ba-the investigator from the CSICand the study's director-presentedhis work in the course of the 2ndBiomedical Seminars, a series ofevents organized by the FJD De-partment of Investigation. Dr. Ro-dríguez de Córdoba, who directsthe Molecular Pathology and Ge-netics Laboratory at the CSIC,was also, from 1996 to 2003, theDirector of the Molecular Patho-logy Department at the FundaciónJiménez Dáz. Dr. Rodríguez deCórdoba was responsible forfounding this investigations labo-ratory, created to better bring to-gether the activities of basic andclinical investigation within thefield of human genetics.

Dr. Elena Goicoechea de Jorge,a biochemist on the immunologyteam of the Center for BiologicalInvestigation, is the paper's firstauthor.

The project has identified newgenes and genetic factors tied tothe complement system which pre-dispose people to atypical HUS.

The complement system con-sists of some 30 proteins and is a

fundamental component of the in-nate immune response to infec-tion. Complement dysregulationof innate immunities is the trigge-ring factor in the illness. Rodrí-guez de Córdoba believes thatknowledge of this process facilita-tes the design and development oftreatment strategies.

This team from the CSIC, alongwith other laboratories, had pre-viously demonstrated the geneticlink between the illness and muta-tions in the genes which encodecomplement-regulatory proteins.

Nonetheless, remarks Rodrí-guez de Córdoba, “in sixty or se-venty per cent of atypical HUS

patients, it is unclear which genepredisposes them to the illness,and it is also not clear why a highnumber of family members ofatypical HUS patients, having thesame mutations as they do, do notdevelop the illness."

Working on the project alongwith the CSIC team were Luis Ca-rreras of the Hospital de Belvitge(Barcelona, Spain); Pilar Sán-chez-Corral and Margarita Ló-pez-Trascasa, both from the Hopi-tal de la Paz (Madrid, Spain); andClaire Harris and Paul Morganfrom the University of Wales(United Kingdom).

CLINICAL MANIFESTATION

HUS is a disorder of the small,functional structures and vessels in-side the kidney, clinically definedas thrombocytopenia and microan-giopathic hemolytic anemia (plate-let deficiency). Manifestations ofthe illness are hematuria (blood inthe urine), oliguria (decreased pro-duction of urine), and renal failure.HUS is a severe and potentially fa-tal illness. It is most commonlyfound in children between 6months and 4 years old, though itcan affect people of any age.

PRESENTED AS PART OF THE 2ND FJD BIOMEDICAL SEMINARS

A study by the Spanish National ResearchCouncil Identifies a Gene Conferring HighRisk for the Development of Acute RenalFailure in Children

An image from the seminars heldin the main lecture hall of the FJD.

Update course inOphthalmologyfor OccupationalPhysicians

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April 2007 ImPULSO

The Fundación Jiménez Dí-az Fire Safety Plan has be-en officially approved. On

November 24th, 2006 the FirePrevention Department of theMadrid City Hall gave its formalapproval to the fire safety plan.

It was a high priority for themanagement to establish a fire sa-fety plan according to current le-gislation in the AutonomousCommunity of Madrid. To do so,once the different options wereweighed, we decided to bring inan outside company whose workwould be to offer overall safetysolutions. Supervised by the FJDOccupational Health and Work-place Hazard Prevention Serviceand in collaboration with manyother people, the process consis-ted primarily of two components.

On the one end, a complete studywas carried out in terms of buil-ding safety, assessing the activitythat takes place in it. Also, exis-ting risks were identified and eva-luated, and prevention and protec-tion measures already in placewere noted. On the other hand,the study took account of the or-ganization and training of person-nel resources that we will need.The human side is vitally impor-

tant since solid organizational ca-pacity is crucial in providing rapidand, above all, effective responseto the possible adverse events ac-companying cases of emergency.

A partial emergency drill washeld on June 12th of last year inwhich participants rehearsed pro-cedures for a fire on the 4th-floorlaboratories of the InvestigationDepartment. We noted a very go-od response from the employeesworking in the area as well as the

safety teamswho collabora-ted in the eva-cuation.

The Fire Sa-fety Manual hastwo clearly de-fined objecti-ves: in formalterms, we loo-ked to complywith existingnorms; opera-tionally spea-king, preven-tion and contin-gency plans incase of emer-gency were laiddown. The for-mer was createdbased on theMadrid regio-nal governmen-t's acceptanceof our Fire Sa-fety Plan, whilethe latter must

be continually updated and canonly be realized with the activedevelopment and participationfrom within our organization.

Therefore, we believe that theFire Safety Plan should be a workin progress in which, as well asaddressing the technical needs de-tected in the study, new variableswill continue to appear, such aschanges to the building, functio-nal, legal, and organizational

changes, etc., all requiring newcorrective measures. A technicalstudy is now in place which setsforth a series of priorities foradopting corrective measures thataffect the different fire safety pro-tocols.

ORGANIZATIONAL STRUCTURE

The internal organization hasbeen set forth based on a pyramidresponsibility structure which ta-kes into account the differentshifts and the people that workthem.

-Internal Catastrophe Com-mittee: Responsible for suppor-ting, when necessary, the Head ofEmergencies in organizing eva-cuation and the actions related toemergency response.

-Heads of Emergencies: Ma-nager or Medical Director or He-ad of On-Duty Medical Unit

Mission: Lead and coordinateemergency actions. Order evacua-tion. Solicit external help.

-Heads of Intervention: Risk-prevention specialists or Heads ofMaintenance, or On-Duty Nur-sing Unit Supervisor.

Mission: Inform the Head ofEmergencies on the emergency.Lead operations on the emer-gency site.

-Second Intervention Teams:63 employees of different profes-sional categories, from differentdepartments, and with a specifictheoretical-practical training inemergency response. Of these, 38have operational status (with bee-pers) for six-month periods at a ti-me, with 8 people working shiftsat a given moment. The rest havepermanent beepers assigned tothem for long-term availability.

Mission: Support and substitu-te for the team of first-line inter-vention. Handle emergencies withthe use of fire-extinguishingequipment. Support outside auxi-liary services.

-Alarm and evacuation te-ams: 131 employees working inall the different services in thehospital, serving to divide the hos-pital into different areas: inpatientarea, central services, administra-tion, laboratories, special servi-ces, etc.

Mission: Attain knowlege ofevacuation routes and personnelmeeting places, so as to directthem to these areas. Help patientsremain calm. Guarantee notifica-tion for all people occupying thearea and the floor and ensure thatall are evacuated in an orderly fas-hion, etc.

-Support Team: Maintenancepersonnel, receptionists, and out-side security personnel.

Mission: Perform proceduresof a technical nature (e.g., cutelectricity lines, medicinal gases,etc.). Facilitate the entry of exter-nal support services. Order inter-nal movement of people, etc.

-Switchboard:Mission: Receive emergency

alerts and internally transmit the in-formation to the Head of Emergen-cies, the Head of Intervention, theAlarm and Evacuation Team, theSecond Intervention Team, the Sup-port Team, and the emergency tele-phone number 112, if necessary.

Emergency Management DeskSwitchboard extension 9

Fire Safety Plan:Work in Progress!

Place where evacuees shall con-gregate in the event of an emer-gency. Indoor meeting places: •Nearest stairwayOutdoor meeting places:•In front of the Cristo Rey Buil-ding exit•In front of the Reyes CatólicosBuilding exit•In front of the InvestigationBuilding exit•In front of the Private SectorBuilding exit

Exits and meetingplaces

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April 2007 ImPULSO

Nursing

One of the tasks that the committee laiddown clearly from the beginning wasto create a report chronicling the cen-

ter's investigation activity in nursing over thepast five years. Included in this report is allmulti-level participation in or commitment tointernal projects and collaborative efforts, thusserving as a probe to locate professionals inte-rested in investigation. In order to collect thisinformation, a data-gathering sheet is beingcirculated among the different wards.

Once this information is analyzed, we willhave obtained an overview of our institution'sinvestigation projects. This will allow us to re-cognize the people who have spent many hoursof their careers in such projects and also attractyoung professionals with a desire to participa-te in investigation. Given this three-prongedperspective, we would like to thank all who ha-ve filled out the survey for your cooperation atthe same time that we encourage the rest to dothe same, especially if you would like to joinone of these projects.

As a first step, the committee would like tostress the importance of belonging to a societyof nursing science. These organizations provi-de enriching experiences, both for the personalbenefit that we receive in our development andgrowth as professionals and as individuals, aswell as what we ourselves bring to the table.The majority of these organizations hold offi-cially-accredited continuing training coursesfor nurses to learn more about their particularareas of work, and they also have publicationsaddressing an array of relevant issues to thesedifferent fields of the profession. Societies ofnursing science also organize multi-center stu-dies in which members can participate directly,design national protocols, or protocols on aEuropean level. In sum, these activities bringvalue to the profession and personally enrichall who participate in them.

As a group whose responsibility it is to en-courage your involvement in investigation pro-jects, it is our belief that joining one of these as-sociations is a good motivating factor. Mem-

bership will allow you to learn first-hand whatpeople who work in our field are doing, stay intouch with patients' requests, determine whatdifferences exist in terms of approaches and ca-re measures, discover what is being investigatedand how-and all of this can create new interestsand issues of study, leading to new points of in-vestigation that you may want to look in to ei-ther on your own or in collaboration with others. The Web site offering a directory of societiesof nursing science in Spain is as follows: http://www.terra.es/personal/duenas/asocia.htmIt may also be of interest to explore theseothers, with user-friendly resources for peopleinteresting in nursing investigation:http://www.index-f.com/ (a digital campus;here you will find different training opportuni-ties, both through distance learning as well asclassroom training. In addition, this Web sitehas a wealth of other interesting information)www.fisterra.comhttp://www.scele.enfe.ua.es/web_scele/red_in-vestigac.htmhttp://www.guiadeenfermeria.com/otros/in-vestigacion/index.htmlThe committee works with you in mind, andwe encourage you to contact us, because yourcuriosities are ours.María Barat (ICU) mbarat@fjd.esTeresa Castillo (Unit 33) mtcastillo@fjd.esAgustina Borrás (Unit 36) aborras@fjd.esÁngela González (Operating theater) Agonza-lezH@fjd.esMarta García (Unit 33) mgarcia@fjd.esEsperanza Vélez (coordinator) (Dialysis Unit)evelez@fjd.es

FOR ALL NURSES INTERESTED IN INVESTIGATION

The Committee for theAdvancement of NursingInvestigation Gets Rolling

The end result of a process which begins whenan investigator considers that he or she hasnew findings to report on, and thus determi-nes that it would be beneficial to add them tothe body of previously established knowledge:Types of presentationsWritten submissionsOral presentations

TYPES OF ARTICLES

Voluntary submissionOriginal article Objective: Inform on the re-

sult of a clinical or experimental trialBrief summaries. Objective: Abbreviated in-formation of all types: preliminary investiga-tion findings, a series of similar clinical cases,technique description, etc.Clinical note. Objective: Provide relevant in-formation on a unique clinical observation.Special article. Objective: Address a currentissue related to similar disciplines.Letters to the director. Objective: Favorable orunfavorable opinion on an article published inthe magazine (within 6 weeks of publication).By request of the editorial committeeReview Objective: Account of a detailed studyon a specific topic (i.e., "update").

Opinion article. Objective: Convey a personalopinion (based on scientific knowledge or ex-perience) on a controversial issue.

STAGES IN THE CREATION OF A SCIENTIFIC PAPER

ApproachAssess the study's real importance.Decide on the type of article (e.g., original ar-ticle, review, opinion, etc. and adjust its struc-ture and its objective accordingly).Establish authorship (Royal Legislative De-cree 1/1996 of April 2nd).Choose the appropriate publication accordingto the article topic and the periodical's area ofinterest.PreparationProvide material (i.e., documented evidencefrom the investigation).Make an initial outline.Gather a bibliography based on appropriate-ness and exhaustiveness of sources.Writing (drafts)Submission to the publication after consul-ting the magazine's guidelines for authors.

Nursing Investigators’ Corner

In this section, we will include relevant information both for investigation as well as for thepublication of findings. Ideally, it will provide us with a context to respond to your curio-sities and needs. Therefore, we encourage you to send us your suggestions and potential to-

pics to be included in this section. Convinced as we are that the dissemination of informationbrings scientific support to nursing professionals, we have created this space with basic infor-mation on publishing in scientific journals.

Publishing in scientific journals

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April 2007 ImPULSO

The 2nd International Mee-ting on Translational Me-dicine and Individualized

Care, which took place on Fe-bruary 8th, achieved its goal ofbringing together experts from allover the world to engage in highlysophisticated discussion and de-bate. The experts gathered for themeeting discussed the new phar-maceutical tools that have beenmade available thanks to complexand profound research on illnes-ses that pose serious problems indeveloped, developing, and un-der-developed countries.

In addition, the content of themeeting was geared toward what

these new resources can contri-bute to personalized medicine, afield which seeks to provideeach patient with a custom-madesolution to his or her health pro-blems.

EIGHT SYMPOSIA

Those in attendance took part ineight symposia on the new vac-cines of the 21st century; strate-gic application of antiretroviraldrugs that have recently come in-to the fight against AIDS; the la-test advances in reproductivemedicine; new insights into me-dicine and aging; and advancesin diagnosing and treating colo-

rectal cancer, neurological, der-matological, and nephrologicaldiseases.

In addition, two master clas-ses were conducted by the guestsof honor: Professor José Esparzaof the Bill & Melinda GatesFoundation, and Professor Jo-seph Torrent Farnell of the Euro-pean Medicines Agency, who to-gether made this event onceagain one of the most innovative,creative, and advanced in thefield of scientific training in ourcountry.

Real-life application of newand revolutionary knowledge onmolecular biology in clinicalpractice should be understood asa new form of investigation, ca-lled “translational investigation”.Its aim is to bring laboratory dis-coveries to clinical practice bycontributing to improvements indiagnosis, treatment, prognosis,or prevention of human illnesses.

IN-HOSPITAL SUPPORT

Coupling aspects of basic scien-ce with clinical investigation,translational investigation can-

not be carried out exclusively intraditional university depart-ments or in centers for investiga-tion without hospital access. Onthe other hand, institutions likethe Fundación Jiménez Díaz,where both types of investigationhappen all under one roof with ahigh level of care quality, areideal settings for this type of ac-tivity.

This, the second internationalmeeting to come to the FJD, hasbeen a meeting place for profes-sionals of different medical andscientific disciplines in which ex-perts were able to get updates onand share know-how on the latestadvances in treating highly pro-blematic issues in public health.These advances have come aboutthanks to complex, profound ba-sic and clinical investigation.

The content of the meetingwas geared toward the contribu-tions made by new therapeutictools to personalized medicine, afield which seeks to provideeach patient with a custom-madesolution to his or her health pro-blems.

ORGANIZED BY THE FUNDACIÓN JIMÉNEZ DÍAZ

The 2nd International Meeting on TranslationalResearch and Individualized Medicine

Inaugural table of the 2nd International Meeting in the FJD.

Jesús González Cabrero re-ceived his degree in BiologicalSciences from the UniversidadComplutense and wrote his doc-toral thesis in our institution un-der the guidance of Dr. JesúsEgido. His investigation was fo-cused on immune mechanismsin IgA Nephropathy, and hiswork appeared in scientific jour-nals in Spain and abroad. After-

ward, Dr. González went on tothe Dana Farber Cancer Instituteat the Harvard Medical School inBoston for an extended post-doctoral fellowship. Jesús laterrejoined our investigation de-partment as an assistant. Duringthis time, he worked in severalareas of investigation in theNephrology Laboratory, wherehe analyzed the role of adhesionmolecules in cardiovascular di-sease and the modulation of en-dothelial adhesion and inflam-matory infiltrate through the useof drugs that inhibit the produc-tion of cholesterol, which heachieved by investigating newmolecules as potential anti-in-flammatory drugs to combat the-

se diseases. His scientific rigorand quintessentially meticulouspersonality forever guaranteedcareful work which produced un-questionable results. Jesús wasnot one to balance work and ple-asure, and he spent the majorityof his time-weekends notwiths-tanding-in the laboratory readingarticles, analyzing data, or wri-ting manuscripts. We all remem-ber fondly his extended sessionswith the fluorescent microscope.

Jesús had a profound unders-tanding of basic molecular andcellular mechanics. He was anexpert in experimental techni-ques in molecular biology, pro-tein-chemical biology, and cellcultures. Timid and reserved, Dr.

González was a true perfectio-nist, though always willing tohelp any of his young and inex-perienced colleagues wheneverthey came to him to ask for hisexpert scientific advice. Jesus,we will never forget the adviceyou gave us in the lab, and wemiss your detailed and preciseexplanations that were so tho-rough that they seemed to havecome straight out of a textbook.Illness caught him unaware. Thebravery and discretion withwhich he faced his illness is anexample for all. Until the veryend, he looked forward to retur-ning to his work in the lab-“Be-cause that's what I do.” Thankyou for everything, Jesús.

IN MEMORIAM

JesúsGonzález

11

April 2007 ImPULSO

Teaching/Investigation

Manuel de Oya Otero was born in Ma-drid on July 16th, 1941 to a well-to-do family of Galician origin. His fa-

ther, also a doctor, was a personal friend of Car-los Jiménez Díaz, and together the two laid thebuilding blocks for a school of medicine. Thisschool was to become the Fundación JiménezDíaz, which would be the setting for ProfessorManuel de Oya's professional career.

Oya studied medicine in the UniversidadComplutense de Madrid, graduating in 1965with highest honors. In 1966, Oya entered theFJD as an intern, and in time he became certi-fied as a specialist in internal medicine and en-docrinology.

In 1969, Oya was awarded a grant by theFundación Juan March to study abroad; his des-tination was the Jay Phillips Laboratory at theMount Sinai Hospital (University of Minneso-ta). His time there lasted until September 1970.During this period, he worked with ProfessorFrancisco Grande Covián, thus beginnig his in-tense career as an investigator. Once back inSpain, he returned to the FJD to collaborate inthe Department of Metabolism, Nutrition, andHormones with Professor Serrano Ríos.

WORK AS A TEACHER AND AN INVESTIGATOR

In 1972, Oya successfully defended his doctoralthesis in the Universidad de Santiago de Com-postela, earning highest honors once again. Na-med Assistant Professor of Pathology and Clini-cal Medicine by passing the competitive examfor the post, Oya began his long career as aneducator in 1974 at the Universidad Autónomade Madrid (UAM) Medical School. In February1987, Oya became a full professor of internalmedicine at the UAM Medical School, wherehe was to carry out his work as an academic forhis remaining years. Named Director of thisschool's Department of Medicine in 1989, hewas re-elected to the position twice more, even-tually occupying the post for 10 years, duringwhich he became the driving force behind thecreation of teaching positions in his dear FJD. In1986, he made the FJD the first Spanish univer-sity to institutionalize a doctoral course on lipidmetabolism, serving as its director.

While carrying out his duties as an educator,he continued his work as a clinician and investi-gator in the FJD. He also coordinated a plan foreradicating toxic syndrome in 1981. In 1996, hewas named Head of the Internal Medicine Servi-ce, later becoming the institution's medical direc-tor from 2003 to 2004, thus providing a pinnaclein his career in the very place where it had begun.

Beginning in 1977, his investigation activi-ties were centered on studying human lipid me-tabolism. This field dominated his career for al-most thirty years. Oya created the FJD LipidsUnit in 1985 in order to bring together the clini-cal and basic investigation components in thestudy of lipid disorders and their relation to

atherosclerosis. Hisfour areas of investi-gation can be summa-rized as follows:

1. Studies of gene-tic hyperlipoproteine-mia in Spain. Dr. Oyawas the first to detaila case of hereditaryhyperchylomicrone-mia in our country,and in 1980 he publis-

hed the second-ever internationally-distributedstudy detailing an extended family with hete-rozygous familial hypercholesterolemia. Follo-wing this accomplishment, he continued clini-cal studies on familial hypercholesterolemia.

2. In 1989, he and his friend Rafael Carme-na carried out the first large-scale pharmaceuti-cal study using cholesterol synthesis inhibitors(statins, or HM-coA reductase inhibitors) in ourcountry, becoming one of the first to do so inEurope. With the backing of the Spanish So-ciety of Arteriosclerosis, he made known theimportance of cholesterol as a cardiovascularrisk factor (lipid hypothesis for arteriosclerosis)as well as the need for dietary and pharmaceuti-cal treatment. Oya's participation was decisivein creating consensus and laying down recom-mendations for preventing heart disease, colla-borating with his friend Juan Cosín in epide-miological and prevention studies such as theEstudio Prevese, in which the two establishedthe reality behind risk-factor control in Spain.

3. Another of his areas of investigation dealtwith nutrition studies and the effect that the dif-ferent types of fats that people take in have. Oneof these fats that Oya devoted a great deal of ef-fort to were monounsaturated fatty acids like theones found in olive oil; his work investigatedthese fats' impact on plasma lipid and lipoproteinlevels as well as on other issues related to athe-rosclerosis development. Manuel gave an ac-count of one of the primary mechanisms relatingolive oil to good health; he found that consu-ming olive oil reduced the variant of cholesterollinked to atherosclerosis development (LDLcholesterol) at the same time that it raised thetype of cholesterol capable of preventing athero-genesis (HDL cholesterol). These projects had asignificant international impact and became thebasis of a campaign led by the European Econo-mic Community in 1990 on the matter.

4. In 1997, he and his wife, Carmen Garcés,began a joint project with the help of a multidisci-plinary team of superb scientists and good friends,launching the project “Estudio Cuatro Provin-

cias,” a four-province epidemiological analysis oncholesterolemia and metabolism disorder in scho-ol-age children. This effort was a continuation ofOya's studies he had begun. The Cuatro Provin-cias study included children from regions ofSpain with traditionally different rates of heart di-sease. The project examined dietary, biochemical,hormonal, and genetic aspects potentially linkedto adult development of cardiovascular disease.Their work has given way to ten doctoral thesesand twenty academic publications.

It would be difficult to provide a completelist of the many collaborators and students whopassed through his lipid metabolism unitthroughout the many years and areas of investi-gation. However, some with special relations-hips with Dr. Oya based on mutual admirationcannot go unmentioned: Luis Álvarez-Sala,Juan Antonio Garrido, and Carlos Lahoz.Others who found in Oya something of a pro-fessional father figure were Mercedes, Henar,Quique, Bea, Laura, and Iria.

He was a founding member of the SpanishSociety of Arteriosclerosis (SEA), serving as itspresident from 1992 to 1996. (He also presidedover the 1st National Congress of the associa-tion in Madrid in 1989.) From 1992 to 1994,Oya was the spokesperson and vice president ofthe European Society for Clinical Investigation.In 1990, he became the scientific coordinatorfor the European Economic Community cam-paign promoting olive oil consumption. 40 doc-toral theses were written under his advisorship,and he wrote in a substantial number of domes-tic and international publications.

A DECENT MAN, ENAMORED WITH HIS PROFESSION

Among many other things, Manuel de Oya wasa good and generous man who was enchantedby his profession. Good in the deepest sense ofthe word. He believed in human kindness andintegrity, tools he often employed in the searchfor solutions to problems that arose in his work.Oya's vision on life and science were suffusedwith nobleness. His generosity was plain to seein his capacity for making the problems ofothers his own, and in his penchant for doingwork that could benefit people or institutions.An academic at heart with a powerful intellect,he was a lover of medicine and felt passionateabout investigation and education. Oya approa-ched his scientific career with great honesty, de-dication, and enthusiasm. All who collaboratedwith him in his final years were swept up by hisoverwhelming spirit. Because of his exquisitebackground as a humanist, he was an exceptio-nal man who knew how to enjoy a great deal ofthings in life at the same time that he madeothers enjoy them as well, like love, friendship,satisfaction at a job well done, music, art, travel,and what some consider to be more mundanepleasures like sailing, cars, and good food.

Dr. Carmen Garcés

RememberingProf. Manuel de Oya

www.capiosanidad.es

12www.capiosanidad.es

ENFERMERÍA April 2007 ImPULSO

Celiac disease is characterized by chro-nic gluten intolerance provoking aller-gic reactions of the digestive system.

Celiacs who ingest gluten experience intestinalinflammation which makes them unable to ab-sorb nutrients. To recover, these people mustfollow a gluten-free diet. It is sometimes verydifficult to diagnose celiac disease since manypatients present only minor symptoms. Glutenis a protein found in cereal grains such as whe-at, barley, oats, rye, and triticale. It inflamesthe intestinal area of people who have a gene-tic predisposition to the disease.

HIGH PERCENTAGE OF THE POPULATION

Affecting 1 out of every 200 people, celiacdisease is the most common chronic disease ofthe intestines. 1 in 20 people who report ha-ving “digestive problems” such as in diarrhea,gas, constipation, and abdominal distensionare celiacs. Because of the existence of caseswith few symptoms or no symptoms at all,many people go without diagnosis. This highnumber of undiagnosed cases is behind manyspecialists' claims that we are just hitting the

tip of the iceberg. While it was once believedthat the condition only affected children, moreand more adult cases are being diagnosed.Many adult celiacs present a variety ofsymptoms. Unexplained osteoporosis or repe-ated miscarriages without a clear cause maypoint to the disease. Given that it is a geneticillness, more than one person in a given familycan have celiac disease.

Typical symptoms are weight loss, stuntedgrowth in children, diarrhea, flatulence, abdo-minal distension, or pain. Nonetheless, atypi-cal manifestations vary from fatigue, anemiabrought upon by a lack of iron, sub-averagegrowth, osteoporosis, infertility, miscarriage,

depression, or some skin diseases such as her-petiform dermatitis. Some people may evenhave a total lack of symptoms.

The first step in diagnosing celiac disease isa blood test. If the result is positive or if thereis good reason to suspect the disease is present,the results must be confirmed with an intesti-nal biopsy performed through endoscopy.

Treatment consists of a life-long gluten-freediet. Therefore, celiacs are advised to eat healthyfoods consisting of natural products such asfruit, vegetables, legumes, and gluten-free cerealgrains such as rice and corn. Now celiacs can en-joy gluten-free bread, cookies, pasta, and the li-ke. They can also consume milk, meat, andeggs. Pre-packaged and pre-cooked meals thatmay have been prepared using gluten should beavoided. Some examples of these are fruit insyrup, lunch meats, etc. Celiac associations giveadvice to those with the illness and their fami-lies, helping the patient have a normal life.

Dr. Pilar RiobóAssistant Head of

Endocrinology and NutritionCapio-FJD

CELIAC DISEASE

Gluten? No, thanks

Throughout its 13-year exis-tence, the Fundación Jimé-nez Díaz Assisted Repro-

duction Unit has incorporated thelatest techniques in its field in or-der to offer patients the finest per-sonalized care.

Specialists working in the unitdesign individualized treatmentstaking into account the humanand medical needs of each case.This allows for immediate carewithout waiting lists or delays.

The investigation, teaching, andcommunication areas continue to behigh priorities. Since it is a teachinghospital, highly-qualified professio-nals in human reproduction havetrained and practiced in the center,and many of them now work inother prestigious institutions.

The unit is made up of seasonedspecialists in the field of reproduc-tion. Dr. Hernández and Dr. Cortésadminister daily clinical care inclose partnership with Dr. Rodrí-guez and Dr. Linares, who managethe work in the laboratory.

The hospital's genetics servicegives invaluable support in diag-nosing and genetically counse-lling infertile couples in need oftheir expertise. The advice givento these couples then becomes anessential component when carr-ying out such innovative techni-ques as preimplantational geneticdiagnosis.

Surgery is performed in theOutpatient Surgery Unit (OSU),where patients receive professio-nal care from highly qualifiedpractitioners acutely attuned tothe human side of their work.Women are able to wake upalongside their partners.

The unit is supported by a gre-at variety of professionals specia-lizing in gynecology, obstetrics,neonatology, andrology, urology,and clinical psychology just to na-me a few. All patients who recei-ve care in the Fundación JiménezDíaz-a tertiary care center that of-fers all medical-surgical special-ties-enjoy comprehensive treat-

ment with all the latest advance-ments in biomedicine.

A TWO-PERSON PROBLEM

Sterility is a dilemma that affectsboth partners in a relationship.

Statistics show that one in six cou-ples suffers from infertility. Inmany cases, the man and the wo-man both present slight fertilityproblems which together decreasetheir potential to have children.Nowadays, infertility stemmingfrom either of the two partners'irregularities is responsible for60% of couples incapable of ha-ving children. (There is no diffe-rence in the number of infertilemen and infertile women.) 30% ofcouples unable to reproduce isbrought on by both partners' con-ditions, and 10% of infertile cou-ples defy clinical explanation.

Information and appointments902111152

Reproduction Center:915504800 (2601)

Reproduction Laboratory:915504868

FJD Reproduction Unit specialists.

OFFERING OF SERVICES

Assisted Reproduction Unit

OUTSTANDING TECHNIQUES

The Reproduction Unit has themost outstanding assisted re-production treatments andtechniques:•Ovulation induction•Conjugal artificial insemina-tion (CAI)•Artificial insemination withdonor semen (AID)•In vitro fecundation•Intracytoplasmic sperm injec-tion techniques (ICSI)•Preimplantational geneticdiagnosis techniques(PGD)

13 www.capiosanidad.es

April 2007 ImPULSO

OurSpecialists

COAD is a preventable di-sease, and the fact that itsprimary cause is smoking

lends greater importance to anti-smoking campaigns. The Spa-nish Society of Pneumology andThoracic Surgery (SEPAR) sup-ports the initiatives led by theMinistry of Health fosteringcampaigns to prevent and controlsmoking. Over 34% of the Spa-nish population smokes, and peo-ple between the ages of 16 and25 have the highest rates of to-bacco use. We have learned thatmore than 20% of people whosmoke an average of half a packa day for 15 years or more run therisk of developing COAD, andthat the disease is now affectingyounger and younger people.Nowadays, some people underthe age of 40 have begun suffe-ring from COAD.

Contrary to may people's be-lief, COAD is a treatable disease.It is widely (though erroneously)thought that existing treatmenthas little effect. Many people ba-se their pessimistic outlook regar-ding COAD prognosis on the lackof cured or halted cases; accor-ding to this belief, doctors can do

little to alleviate symptoms. Ho-wever, we know that this in notentirely true. The fact is that sincethe 1970s, oxygenotherapy has in-creased survival rates, and quit-ting the habit early prevents pro-gressive lung deterioration.

PERCENTAGE OF THE POPULATION

AFFECTED AND DIAGNOSIS

In Spain, only 9% of the adult po-pulation with COAD has beendiagnosed. 80% of people withthe disease are unaware of the factand therefore do not seek treat-ment-and when they do, their con-dition is often already in an ad-vanced stage. Late diagnosis in-creases the danger of complica-tions such as respiratory insuffi-ciency or exacerbated respiratoryinsufficiency. One of the possiblecauses of this low rate of diagno-sis is insufficient use of spiro-metry in primary care contexts.Another contributing factor maybe the long period of mild se-riousness with few symptoms,thus causing smokers to confusewhat they are experiencing withthe natural dyspnea that accompa-nies aging or, in other cases, smo-kers' cough. COAD is diagnosed

through obstructive spirometry(FEV1/FVC ratio lower than70%) on the basis of a compatibleclinical picture. Spirometry testsare diagnostically ineffective ifused as a sceening element for thegeneral population. However,when administered in the contextof a clinical examination on pa-tients considered to be at high riskof having COAD, it can be ahighly effective tool, thus makingit a recommendable procedure forall smokers over 40 who presentany kind of respiratory symptom.Nowadays, small portable spiro-metry systems are making for mo-re widespread use in primary caresettings.

SOCIAL AND ECONOMIC IMPACT

COAD affects individuals, theirfamilies, and society as a whole.In its initial phases, the diseaseputs great strain on social-welfa-re and health-care services owingto its potential to incapacitatethose who suffer from it and thehigh incidence of exacerbationseen in these phases. This alsomeans increased costs includingdirect costs stemming fromdrugs, hospitalizations and other

care services as well as indirectcosts incurred when patients areforced to take leaves of absenceor when family members need tocare for them. In Spain, morethan two billion euro each yeargo to the direct costs of treatingthe disease.

MORTALITY

Each year, 3 million people diefrom COAD throughout theworld, making it the fourth-lea-ding cause of death on the planet.15,000 Spaniards succumb to thedisease each year. COAD is theonly avoidable cause of deathwhose rate has increased in recentyears. In the coming years, it is fo-recasted to increase in prevalenceand become the third most com-mon cause of death in the world.However, comparisons of the sur-vival rate between the 1970s andpresent time indicate a clear im-provement. Patients who have be-en diagnosed and treated now livelonger, but in general, the popula-tion at large has yet to be diagno-sed. Therefore, these people donot reap the benefits of treatmentand have a higher mortality ratecaused by the illness. Smoking in-creases the incidence of COAD,but the rate of diagnosis has notchanged.

PROSPECTS

We at the FJD Pneumology Unitwould like to see an increase inthe percentage of people withCOAD who are diagnosed. Thiscan be brought about by increa-sing the use of spirometers so thatpatients may have greater possibi-lities for attaining care and bysupporting anti-smoking cam-paigns to decrease the number ofsmokers throughout the world.Available treatment techniquesare highly efficient and allow forcombinations with drug regimenswhich increase efficiency evenfurther. Also, new data lendstrength to the possibility of inha-led steroids to reduce COAD mor-tality -treatment options that allowus not to leave patients defense-less against their disease.

Dr. Germán Peces-BarbaAssitant Head of the Pneumo-

logy ServiceCapio-FJD

CHRONIC OBSTRUCTIVE AIRWAY DISEASE CAN BE PREVENTED AND TREATED

Tobacco or Good Health: You DecideCaused primarily by tobacco smoke, Chronic Obstructive Airway Disease (COAD) is an inflammatory conditionwhich obstructs people's airways. It cannot be totally reversed. Two key concepts added by the European andAmerican COAD societies to this most recent base definition have led to a new way of thinking about the dise-ase: “COAD is preventable and treatable.”

COAD diagnosis is determined by obstructive spirometry.

14www.capiosanidad.es

April 2007 ImPULSO

Nosocomial infections, de-fined as those producedwithin a hospital, greatly

increase morbidity and mortality,straining resources and bringingsuffering to many patients. Ex-perts believe that nosocomial in-fections are most easily spreadby health professionals' handscarrying the disease. In somecircumstances, hospital policiesgeared towards increasing thefrequency with which hospitalstaff wash their hands has redu-ced the incidence of nosocomialinfections, but not in all of them.Failure to totally eradicate the di-sease has not discouraged manyhealth services in neighboringcountries or our own from laun-ching enthusiastic nation-widecampaigns promoting handwas-hing.

But this is not only a problemin hospitals. The most commoninfections such as colds, flu, orgastrointestinal infections (infec-tious diarrhea) are primarily tras-mitted through contact.

We wash our hands infre-quently, we do not wash themwhen necessary, and we do it po-

orly. People should wash theirhands before and after eating orgoing to the bathroom, wheneverthey touch animals, before andafter preparing food, after blo-wing their noses or sneezing, be-fore and after treating a wound,after touching a sick person, justto name a few. When washingyour hands with water, wet themwell up to your wrists, use amplesoap and scrub vigorously. Donot forget to scrub your finger-nails, the spaces between fingers,and the backs of your hands.Then, rinse all the soap off, dryyour hands with a disposable to-wel whenever possible, and use itto turn off the faucet before thro-wing it away.

TRAINING AND INFORMATION

In our hospital, we are currentlydeveloping a strategy to addressthis issue. Judging from othercenters' experience, it is clearthat a solid commitment is nee-ded from the Managing Director.Posters and such are absolutelyuseless if not coupled with an in-tensive education campaign thatincludes the hospital's opinion le-

aders, service heads, medical di-rectors, nursing supervisors, andthe like. It is also necessary to gi-ve feedback to those involved,providing them with the resultsobtained and the increase in thenumber of personnel who washtheir hands correctly at the rightmoments. Ideally, members of

the community should receive in-formation on the effects that thecampaign has on the rate of no-socomial infections.

One factor which people assu-me is important though whichlacks exact quantification withinthe formula of nosocomial infec-tion is general hospital cleanli-ness. Aside from the astheticcomponent, which is in it selfquite important, it is clear that aclean environment stimulateshygienic behavior. In this senseit is important to point out thatmuch of this general cleanlinessis in our hands and is plain tosee: in our hands meaning inas-much as we act while in the hos-pital as we would (or believe weshould) act in our homes. Andwhen we say that proper cleanli-ness is in plain sight, we meanthat we should not allow our su-rroundings to be filthy or un-kempt.

HYDROALCOHOLIC SOLUTION

Equally but not more importantthan what we have mentionedabove is what product is used forhandwashing and how it is used.It is in our good interest to makethe right decision as to the pro-duct we use, but if we merelybuy the product, distribute itthroughout the hospital and putup a few posters, we may createthe sensation that our work is do-ne. That would be a recipe forfailure. It may be beneficial toimplement community-widehandwashing with a hydroalco-holic solution for all staff exceptsurgical professionals. In addi-tion to being the only productwhose effectiveness has beenstudied in recent publications, itsmost obvious advantages are thatit doesn't require a sink with run-ning water, soap, or a handdryer; also, dispensers can beinstalled at the head of patients'beds or carried around in robepockets; lastly, contrary to whatone might think, it is generallymore cosmetic than repeatedlywashing one's hands with soapand water.

Dr. José Antonio Azofra GarcíaCoordinador Urgencias

Capio-FJD

NOSOCOMIAL INFECTIONS

Did you Wash your Hands?“IT MAY BE IN OUR

INTEREST TO

IMPLEMENT

COMMUNITY-WIDE

HANDWASHING WITH A

HYDROALCOHOLIC

SOLUTION FOR ALL

STAFF EXCEPT

SURGICAL

PROFESSIONALS. THIS

IS THE ONLY PRODUCE

WHOSE EFFECTIVENESS

HAS BEEN STUDIED IN

RECENT

PUBLICATIONS.”

April 2007 ImPULSO

Capio News

15

Paper on “Cardiac Rehabilitation: LatestAdvances in Stem-Cell Research for Car-diac Pathologies"

Doctor Carmen Terzic, associate physi-cian in the Cardiovascular Health Clinic atthe Mayo Clinic in Rochester, Minnesota(U.S.A.), a world-renowned expert in cardiacinvestigation and rehabilitation, recently vi-sited the Capio Hospital Sur de Alcorcón topresent her paper entitled "Cardiac Rehabili-tation: Latest Advances in Stem-Cell Rese-arch for Cardiac Pathologies."

Neurology Service RecognizedThe Neurology Service at the Capio Recole-

tas Albacete, under the leadership of Dr. Luis Ló-pez-Ibor, has been recognized by the NeurologyService of the Complejo Hospitalario Universita-rio de Albacete for the results it has obtained intreating patients with subarachnoid hemorrhagein the context of the partnership that the two cen-ters have. The two centers presented a poster ontheir collaborative project during the Conferenceof the Spanish Society of Neurology in whichthey demonstrated positive results from mana-ging patients with subarachnoid hemorrhage.

New Memory UnitThe Hospital Capio Tres Culturas has for-

ged new territory in Toledo with its recently-opened special examination service treatingcognitive deterioration. The new addition isknown as the Memory Unit. Both the hospita-l's medical director, Dr. María José Salcedo, aswell as the geriatrician who coordinates thecenter's Memory Unit, Dr. Rocío Menéndez,stress the importance of the work which theyand their colleagues do, especially since theirwork is aimed especially toward elderly pa-tients.

www.capiosanidad.es

New Capio Clinic in Talavera de la Reina

The Capio Hospital de Cata-lunya Clinical AnalysisLaboratory recently pu-

blished a leaflet for patientswhich clearly and concisely ex-plains how to collect samples(i.e., stool, sputum, urine, semen,etc.) so that they may be safe fromcontamination and produce accu-rate results.

The leaflet lists the previoussteps that patients should followfor each different kind of test sothat the samples may be collectedat the appropriate moment. It al-so explains how to get the sampleto the laboratory in optimum con-ditions.

Capio Sanidad, with 20centers throughout Spain,now has a new private

day hospital: Capio Clínica deTalavera. The Capio HospitalTres Culturas in Toledo and theCapio Hospital Sur de Madridwere used as reference points forthe clinic's design.

The new center offers top-notch care for its patients thanksto the latest technological ad-vancements, a staff of the mosthighly qualified professionals,and the finest medical installa-tions available. Capio Clínica deDía de Talavera has a wide offe-ring of services, providing spe-cialist attention in such areas aspediatrics, general medicine,dermatology, and clinicalpsychology. Some of the newcenter's most noteworthy surgi-cal specialties are: general di-gestive surgery, ophthalmologi-cal surgery, and traumatologi-cal-orthopedic surgery. The cen-ter is equipped with a surgicalarea housing operating theatersand a recovery room.

These are just a few of theservices offered by Capio Clíni-ca de Talavera. The center con-tinues working to expand its of-fering of services and medicalspecialties in the near future,

and thus offer the finest healthcare to all its patients.

Like all Capio centers inSpain, Capio Clínica de Talave-ra has partnered with the mosthigh-profile mutual benefit as-sociations and insurance com-panies so as to provide access toexcellent health care to the lar-gest number of patients possi-ble. In order to offer its patientsutmost convenience, the clinic isopen Monday to Friday from 10a.m. to 2 p.m. and then from 4p.m. to 10 p.m.

The clinic also has a patient in-formation and help center acces-sible via telephone, where patientscan get answers to any questions

they may have. 925 72 20 36. The new Capio Clínica de

Talavera opens its doors to sta-te-of-the-art technology andhuman efficiency in order togive people the finest in medi-cal care.

CAPIO HGC

Information on handlingsamples

Capio Hospital Sur Alcorcón

Capio Recoletas Albacete

Capio Hospital Tres CulturasToledo

Entrance to the new clinic and aphotograph of one of its rooms.

Capio

DíazJiménezF U N D A C I O N

www.capiosanidad.es

Avda. Reyes Católicos, 2 - 28040 Madrid

Tel. 91 550 48 00

902 11 11 52 Información y Citaciones Sector privado

Juntos seguiremos construyendo futuro

Fundación Jiménez Díaz

Capio Sanidad