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SEDAR president and WFSA vicepresident" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "425" "paginaFinal" => "428" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Gilsanz Rodríguez, E. Guasch Arévalo" "autores" => array:2 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Gilsanz Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "E." "apellidos" => "Guasch Arévalo" "email" => array:1 [ 0 => "emiguasch@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Académico de Número de la Real Academia Nacional de Medicina de España, Honorary Member of ESAIC, Ex - Presidente SEDAR, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "WFSA Council and Board Member, WFSA Obstetric Anaesthesia Committee Member, ESAIC Nominations Committee Member, EBA-UEMS Vice-President, ESAIC Education Committee Member, Bruselas, Belgium" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Luis Agosti Romero (1909–1983). Presidente de la SEDAR y vicepresidente de la Federación Mundial de Sociedades de Anestesiología (WFSA)" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">To commemorate the 70th anniversary of the Spanish Association of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR), we believe it is important to remember the contributions made to science and anaesthesiology by WFSA co-founder and former SEDAR chair (1957–1961) Dr. Luis Agosti Romero.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Luis Agosti was born in Santander (Cantabria) on 30 August 1909. At the age of 5, his family moved to Mexico, and from there to the USA 2 years later, settling in Ithaca, New York State, where he attended primary school before the family finally returned to Spain when he was 10 years old.</p><p id="par0015" class="elsevierStylePara elsevierViewall">He completed his high school education at the San Isidro and Cardenal Cisneros Institutes in Madrid (1921−24), and then enrolled in the Faculty of Science (foundation course 1926–1928) and then the Faculty of Medicine of Madrid’s Central University, from where he graduated in 1933 and completed his doctorate in 1934.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In 1933, the University of Madrid created the National Institute of Physical Education, attached to the Faculties of Medicine and Philosophy and Letters (Pedagogy). There, Luis Agosti worked as an honorary assistant professor for 3 years alongside Dr Blas Cabrera Sánchez (1907–1983). In 1934, he secured the position of resident in "Exercise Physiology” in the Department of Physiology chaired by Prof. Juan Negrín López (1892–1956). In 1936, he obtained his Diploma in Physical Education and was appointed professor of Physical Education at the Institute. Before the outbreak of the Civil War, he participated in several sporting events: swimming, diving, rowing, wrestling, boxing and rugby. He excelled at athletics - winning the 1932 Spanish javelin championship and setting records in decathlon and pentathlon.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In July 1937, at the height of the Civil War, he was part of the large team sent by the Government of the Republic to the Workers’ Summer Olympiad, where he participated in the javelin events. He took advantage of the games to defect to the other side. In the battle of Teruel, he was wounded by a mortar shell, lost a leg and fractured his radius. After his recovery, he led the initiative to create the Orthopaedics and Rehabilitation Centre in Santander to treat the Civil War wounded.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In 1940, he won a post at the Municipal Charity Hospital of Madrid through a competitive exam, and was appointed head of the blood group division of the Spanish Institute of Haematology and Haemotherapy chaired by Dr. Carlos Elósegui Sarasola (1902–1981).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In 1942, as National Physical Education Advisor, he organized the First National Popular Dance and Gymnastics Championships and the First National University Games organised by the Spanish University Union (SEU, in its Spanish acronym). According to Luis Agosti: <span class="elsevierStyleBold">“</span>sport, in its broadest terms, is a form of expression, and that is why each era and above all each nation approaches it differently; therefore, men and women should also practice it differently".<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In 1947, he travelled to the UK under a scholarship from the British Council and studied anaesthesiology at the Welsh National School of Medicine in Cardiff under Prof. William Woolf Mushin (1910–1993), and later in Oxford under Prof. Robert Reynolds Macintosh (1897–1989). He returned to Spain in 1949.</p><p id="par0045" class="elsevierStylePara elsevierViewall">According to Avelino Franco, in 1947, following the return to Spain of Dr. Francisco Elío Membrado (1916–2016) and Dr. Ricardo Vela from the UK, followed in 1949 by Dr. Luis Agosti, Prof. Francisco Martín Lagos (1897–1972), professor of Pathology and Clinical Surgery at the Faculty of Medicine of Madrid enlisted the help of these three pioneers along with Dr. Roberto Llauradó Sabé and Dr. Patricio de Agustín to teach courses in anaesthesiology. The first course was held between February 14 and June 15, 1949, with the collaboration, among others, of professors Fernando Enríquez de Salamanca (1890–1966) and Valentín Matilla Gómez (1900–1997), and was repeated annually for a total of seven years.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The first Spanish anaesthesiologists received their training in these courses,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> among them Dr. JM Gutiérrez Goicochea, Head of the Department of Anaesthesiology, Resuscitation and Pain Therapy at the Virgen del Rocío University Hospital in Seville, who wrote “… around 1953, performing anaesthesia induction with chloroethyl on a face mask followed by drops of ether until sufficient depth had been reached to perform tracheal intubation. At that time, the use of intravenous barbiturates and relaxants, such as curarine, was a luxury that was only indicated in rare and exceptional situations.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In the 1960s, Luis Agosti, now professor of anaesthesiology at the National Thorax Institute, organized a series of annual intensive continuing education courses for anaesthesiologists in which several respected foreign specialists joined the teaching team.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In 1953, the First Meeting of Spanish Anaesthesiologists was held in Granada, coinciding with the 3rd National Congress of Surgery held in that city from September 23–27. The three official presentations were: "Management of hypotension in anaesthesiology", Dr. Luis Agosti Romero (Madrid), "Intravenous Novocaine ", Dr. E. Bruguera Tallada (Barcelona) and "Spanish contribution to the history of curare", Drs. J. Miguel (Barcelona) and R. Vela (Madrid).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Luis Agosti was served as chairman of the Spanish Association of Anaesthesiology (Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy) from 1957 to 1961, and in September 1964 was elected Vice President of the World Federation of Anaesthesiology Societies (WFSA) during the Third World Congress of Anaesthesiology held in Sao Paulo, Brazil - a position he held until 1968. The president of the WFSA at that time was Sir Geoffrey Stephen William Organe (1908–1989). Luis Agosti translated the first WFSA Newsletter published by Springer into Spanish in June 1965. He was an Honorary or “Corresponding” Member of the Anaesthesiology Societies of Cuba, Colombia, Italy and Portugal. In April 1965, he became an Honorary Fellow of the Royal College of Anaesthesiologists during a ceremony presided over by Profs. Thomas Cecil Gray (1913–2008), Sir Geoffrey Stephen William Organe (1908–1989), and Prof. William Woolf Mushin (1910–1993).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">During his professional career he was invited to speak in conferences in several countries, including Uganda, Argentina, Venezuela, Portugal, Italy, and India. By order of March 10, 1966, he was awarded the Cross of Naval Merit, third class with white decoration (BOE no. 72, March 25, 1966).</p><p id="par0075" class="elsevierStylePara elsevierViewall">Luis Agosti was a prolific author. On the subject of sports physiology, he published: <span class="elsevierStyleItalic">Sistema porta oxígeno</span> (1943),<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and in 1948, while sub-inspector of physical education, his experience in sports physiology, accomplishments as an athlete, and his time spent teaching gymnastics at the Institute led him to publish <span class="elsevierStyleItalic">Gimnasia educative</span>,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> with a prologue by Prof. Carlos Jiménez Díaz (1898–1967). This leading text book (by order 2-2-1949) commissioned by the Women's Section was re-printed in 1963 and 1974, and was widely praised. Prof. Johannes Lindhard (1870–1947), for example, director of the Laboratory for the Theory of Gymnastics in Copenhagen, after reading the galley proofs wrote: “It is extremely hard to write a book that includes the theory, methodology, and practice of gymnastics in a single volume. However, from what I can see, you have successfully solved the problem. I believe your book will be extremely useful for teachers of gymnastics and other physical disciplines who wish to become familiar with the functioning of the human body and the purposes of gymnastics”. Agosti wrote his treatise from a humanistic approach: "… as [gymnastics] is not about training circus athletes or bookworms, but rather whole, balanced men and women whose bodies are inseparable from their spirit, and who must be educated in this way”. Agosti, who has been considered the father of educational gymnastics in Spain, emphasised the importance of self-control, decision, generosity, courage, tenacity, social awareness, discipline, and attitude in victory and defeat.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Luis Agosti was a member of the editorial board of <span class="elsevierStyleItalic">Citius Altius Fortius</span>, the sports studies journal of the Spanish Olympic Committee from its inauguration in 1959 until 1976. In 1968, he published the article <span class="elsevierStyleItalic">Sobre deporte, deportividad y caza</span>.</p><p id="par0085" class="elsevierStylePara elsevierViewall">His most important articles in the field of haemotherapy include: <span class="elsevierStyleItalic">Aglutinógenos humanos</span> (1944), <span class="elsevierStyleItalic">Cuadro hemático en donantes</span> (1945), <span class="elsevierStyleItalic">Hallazgo de la aglutinina &2, en un individuo del grupo A</span> (1946), <span class="elsevierStyleItalic">Los grupos sanguíneos en Galicia</span> (1950) and the chapter <span class="elsevierStyleItalic">Grupos sanguíneos. Síndromes de inmunización</span>, in <span class="elsevierStyleItalic">Tratado de Medicina Interna</span>, 1959, edited by Prof. Vicente Gilsanz García, Chair of Pathology and Clinical Medicine.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10–14</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">As a specialist in anaesthesiology and resuscitation, in 1957 he published <span class="elsevierStyleItalic">Recientes avances en anestesiología y reanimación</span>, with a foreword by Prof. Carlos Jiménez Díaz, in which he addressed the following topics: <span class="elsevierStyleItalic">The anaesthesiologist’s role in reducing surgical bleeding</span>; <span class="elsevierStyleItalic">Presoparesis</span>; <span class="elsevierStyleItalic">Artificial hibernation</span>; <span class="elsevierStyleItalic">hypothermia</span>; <span class="elsevierStyleItalic">Notes on the phenomenon of anaesthesia</span>; <span class="elsevierStyleItalic">Impact of drugs in anaesthesia</span>; <span class="elsevierStyleItalic">Synthetic antihistamines and their derivatives in premedication and anaesthesia</span>; <span class="elsevierStyleItalic">Pathophysiological problems of the prone position; New techniques for using nitrous oxide</span>; <span class="elsevierStyleItalic">Latest developments in endotracheal anaesthesia</span>; <span class="elsevierStyleItalic">Latest developments in intravenous anaesthesia</span>; <span class="elsevierStyleItalic">Recent approaches to relaxants</span>; <span class="elsevierStyleItalic">Choice of anaesthetic technique in caesarean section</span>; <span class="elsevierStyleItalic">The Analgen device in obstetrics and minor surgery</span>; <span class="elsevierStyleItalic">New cardiac recovery techniques</span>; <span class="elsevierStyleItalic">The baro-regulator</span>; and <span class="elsevierStyleItalic">Recent drugs in regional analgaesia.</span><a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">He also wrote a chapter in <span class="elsevierStyleItalic">Patología y terapéutica quirúrgicas</span>, 1956, edited by Prof. Francisco Martín Lagos, Chair of Pathology and Clinical Surgery, and the addendum to the Spanish edition of the <span class="elsevierStyleItalic">Manual de anestesiología</span>, 1956, edited by RJ Minnitt and J. Gillies.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,17</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Other articles by Luis Agosti include: <span class="elsevierStyleItalic">Resultados de dos encuestas nacionales sobre muertes relacionadas con la anestesia y la reanimación</span> (dealing with errors in the choice of anaesthetic or technique, intrinsic toxicity of the agent, abnormal sensitivity to the anaesthetic agent, errors in the method of administration, technical and instrumental failures, aspiration of vomit, prolonged neuromuscular blockade, hypotension, and reflex-related deaths); <span class="elsevierStyleItalic">Entorno del rito del quirófano. Errores frecuentes en anestesiología reanimación</span> (which describes facility-related shortcomings, errors in oxygen administration, protection of nerve trunks, intravenous infusions, respiratory obstruction, operating room temperature, contamination of anaesthesia solutions, training of auxiliary personnel, cardiac massage, and which was written as a prelude to the introduction of standardization); and <span class="elsevierStyleItalic">Presoparesis</span> (autonomic paresis, advantages and disadvantages, study of coagulation, paresis in the prevention of shock). Controlled hypotension was a technique he championed enthusiastically; <span class="elsevierStyleItalic">Nuestro concepto actual sobre las posibilidades del fluothane en la clínica humana</span> (in which he talks about his experience performing 322 anaesthesia procedures).<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18–27</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Luis Agosti also introduced innovations in anaesthesiology instruments, for example,<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a)</span><p id="par0110" class="elsevierStylePara elsevierViewall">The modified Macintosh laryngoscope, in which the distal end of the laryngoscope blade is grooved. This laryngoscope has 2 ovoid prominences on its distal end that are intended to be placed on either side of the epiglottis. The blade is longer than the standard Macintosh blade. He also redesigned the tip of the endotracheal tube so that the bezel faces backward instead of sideways. When the tube is placed in the trachea, it curves to adapt to the anterior wall.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b)</span><p id="par0115" class="elsevierStylePara elsevierViewall">A dental protector, in the form of a rigid, 3 mm thick metal plate encased in a removable plastic cover that is placed between the premolars to form a bridge on which the blade of the laryngoscope can rest. The plate prevents dental injury without disturbing the glottic view. Agosti, in his 1977 article, described in detail his anaesthesia technique for laryngeal microsurgery, insisting on the importance of dental protection, and accompanied his text with illustrations.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">29,30</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c)</span><p id="par0120" class="elsevierStylePara elsevierViewall">The modified Magill intubation forceps, in which the prehensile tips are rounded to offer a smooth surface in contact with the mucosa, and the arms are bent in the sagittal plane to fit the anatomical shape of the mouth and pharynx and facilitate insertion.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d)</span><p id="par0125" class="elsevierStylePara elsevierViewall">The “Analgen” self-administered inhaler for trilene or chloroform, which consists of a metal container with a lid and an inspiratory and an expiratory valve. The inspiratory valve regulates the concentration of air and anaesthetic, and can be adjusted by the patient. The device was used for obstetric analgesia and minor surgery, and is very similar to the Duke inhaler for trilene developed by Ronald Stephen of Duke University1951−1952, which had a non-rebreathing mechanism to prevent the accumulation of carbon dioxide. The maximum concentration of trilene was 0.3%–0.5%.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,32</span></a></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">e)</span><p id="par0130" class="elsevierStylePara elsevierViewall">The "baroregulator" for the automatic regulation of intrathoracic pressures in the postoperative period of thoracic surgery and for the resuscitation of new-born infants.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,33</span></a></p></li></ul></p><p id="par0135" class="elsevierStylePara elsevierViewall">In his role as a writer and illustrator, his passion for animals and hunting led him to write in 1968 <span class="elsevierStyleItalic">Fieras, selvas y salvajes, África del este y oeste</span>, which he illustrated with his own drawings and photographs. In the prologue, Félix Rodríguez de la Fuente writes: “How thorough Luis Agosti is in his observations. How his training as an eminent doctor weighs on his hunter's soul… A well-carved ashlar stone in the Tower of Babel of hunting literature”.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">As a writer of hunting stories, in 1982 he published <span class="elsevierStyleItalic">Tigres, osos y shikaris. Cacerías en la India y Alaska</span>, also illustrated with his excellent drawings and photographs. Alfonso de Urquijo, in the prologue, remembers his personal experience of Luis Agosti as an anaesthesiologist following a multiple fracture of the wrist: «The doctors decided to give me general anaesthesia to allow them to freely manipulate my complicated fracture, and also a small dose of curare, the poison in which the Amazonian Indians dip their arrows in order to paralyse their prey. This substance, apparently, produces total muscle relaxation. Well, when the effect of the anaesthesia wore off, I thought I was dead because although I could see and hear, I was paralysed and could not breath. I was starting to get very frightened when I heard the distant, friendly voice of Dr. Agosti, telling me not to worry as he gave me a slap that brought me back to life. I can assure you that I will never forget the sound of Luis Agosti's voice at that time".<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">35,36</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">I cannot end this tribute without mentioning another facet of Luis Agosti’s personality, his love of the <span class="elsevierStyleItalic">tertulia</span>, or social gatherings to discuss literature, the arts, or current affairs. He was a member of the <span class="elsevierStyleItalic">La Ballena Alegre</span> [Happy Whale] <span class="elsevierStyleItalic">tertulia</span>, which met in the basement of the Café Lyon, at 59 Alcalá Street in Madrid. In keeping with the name of group, the walls of the basement were decorated with 3 murals by the painter Hipólito Hidalgo de Caviedes (1902–1994). The group, which included several eminent doctors, such as José Estella Bermúdez de Castro, Luis Estella Bermúdez de Castro, Francisco Orts Llorca, José Casas Sánchez, Vicente Gilsanz García, Carmelo Gil Turner, Pedro Matanzo Acevedo, Manuel Tamames Ratero, Juan Manuel Ortiz Picón, together with the writer Francisco Camba and the sculptor Juan Cristóbal, focussed on discussing the events during and after the Second World War in a spirit of liberal acceptance of divergent opinions.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The pioneer of modern anaesthesia, Dr. Luis Agosti Romero, died on May 22, 1983, at the Puerta de Hierro Clinic, and is buried in the Fuencarral Cemetery.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:37 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Citius Altius Fortius. 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Journal Information
Vol. 70. Issue 8.
Pages 425-428 (October 2023)
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Vol. 70. Issue 8.
Pages 425-428 (October 2023)
Editorial
Luis Agosti Romero. SEDAR president and WFSA vicepresident
Luis Agosti Romero (1909–1983). Presidente de la SEDAR y vicepresidente de la Federación Mundial de Sociedades de Anestesiología (WFSA)
a Académico de Número de la Real Academia Nacional de Medicina de España, Honorary Member of ESAIC, Ex - Presidente SEDAR, Madrid, Spain
b WFSA Council and Board Member, WFSA Obstetric Anaesthesia Committee Member, ESAIC Nominations Committee Member, EBA-UEMS Vice-President, ESAIC Education Committee Member, Bruselas, Belgium
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