Free journal Take it home! first quarter 2015
Nº 20
Magazine del Instituto Oftalmológico
F E R N Á N D E Z -V E G A
The Fundación Fernández-Vega and Cambodia, a reality with future
The channel OftalmologíaTV is born
Retinitis Pigmentosa, in the spotlight
pág. 18
pág. 30
Luis del Olmo: I don’t like “everything’s ok”, but “everything can improve” pág. 38
Recognition as an incentive
and that, at the same time, Forbes states that Dr Álvaro Fernández‑Vega is one of the three best professionals in Spain within his field.
Prof Luis Fernández-Vega.
The best recognition to our work is the tens of thousands of patients that distinguish us every year with their trust. 2
Editorial
While it is true that the best recognition to our work is the tens of thousands of patients that distinguish us every year with their trust, it is very satisfying that the Corporate Reputation Business Monitor (MERCO in Spanish) within the Spanish health field, based on thousands of surveys to professionals, includes the medical director and the medical deputy director of the Institute amongst the five best ophthalmologists in Spain
This recognition is undoubtedly due to a continuous effort in which constant training and the use of proven technologies by an excellent team are paramount in the care of patients; in this, the human factor is still the priority. This is the path we chose to follow some decades ago in our professional activity, and we’ll stick to it in the future, supported by the incentive of these recognitions.
About us The Instituto Oftalmológico Fernández-Vega (IOFV) is an Eye Hospital. The surname Fernández-Vega has been linked to the practice of this speciality for over 125 years. At present, the Institute devotes all its efforts to the prevention, diagnosis and medical and surgical treatment of those diseases that jeopardise vision. Currently, the facilities of the Institute in Oviedo occupy a surface area of approximately 12,000 square metres, in which close 200 people work. Every year over 100,000 patients are seen and 8,000 surgeries are performed.
In order to stay ahead in innovation and to return to society part of what its patients have given to the Institute, the IOFV has launched the Fundación de Investigación Oftalmológica (FIO) (Eye Research Foundation). The Foundation carries out biomedical translational research in ophthalmology and vision sciences in conjunction with the generous contribution of other entities and foundations committed to the fight against this disease.
All this activity generates a great teaching capacity for health professionals devoted to vision (ophthalmologists, opticians-optometrists, nurses and Medicine students), it materialises through different pre and post-graduate programmes in collaboration with the Universidad de Oviedo. Furthermore, the Institute cares for disadvantaged people through the Fundación Fernández-Vega, present in Spain as well as in international missions, such as the ones carried out in the past few months in Peru, Liberia and Cambodia.
100,000 patients 8,000 surgeries
About us
3
“High Deenition Vision”
Invisible
Reversible
Proteje tus ojos de los rayos UV
MIRA AL HORIZONTE Y PIENSA EN TODO LO QUE TE QUEDA POR VER
Más del 99% de pacientes satisfechos
MAGAZINE OF THE INSTITUTO OFTALMOLÓGICO FERNÁNDEZ-VEGA Avda. Dres. Fernández-Vega, 34 33012 OVIEDO T. 985 240 141 F. 985 233 288 www.fernandez-vega.com Direction and coordination, content writing and editorial management: Atlántica Empresas Advertising: SGANMEDIOS 678 684 457 Design: Eteria, Marketing y Comunicación D.L. AS 5668-2007
Table of contents pág. 6 Making headlines • The Instituto Oftalmológico Fernández-Vega, case study in the IESE Business School of the Universidad de Navarra • Oviedo, headquarters of the II European Meeting of Young Ophthalmologists • Prof Luis Fernández‑Vega participates in the Forum of El Comercio on “Medicina e industria biosanitaria: oportunidad para Asturias” (Healthcare and Biosanitary Industry: opportunity for Asturias) • The director and the deputy director of the Institute amongst the best physicians of the country • The Institute hosts the XI Spanish National Conference of Health Informers • Our physicians, in Facoelche 2015 • Experts gather at the Institute to analyse the latest news on cataract and presbyopia surgery • Christmas announcement of the Asociación Belenista de Oviedo • The king of Saudi Arabia at the Institute • The channel OftalmologíaTV is born • The mobile application of the Institute, now in English too • The Fundación Fernández-Vega checks the eyestrain of 400 people during the World Glaucoma Day
pág. 23 The most + 2.0 pág. 24 Fundación Fernández-Vega • The Foundation in Cambodia • At the Asociación de Síndrome de Down de Asturias
pág. 30 Medical article/report • Retinitis Pigmentosa, in the spotlight
pág. 32 Art • Ametrine eyes
pág. 34 Our departments, one by one • The importance of a smile
pág. 36 Research • Should one invest in basic and translational research?
pág. 38 They look kindly upon us • Luis del Olmo: “I don’t like <everything’s ok>, but <everything can be better>”
pág. 40 Lets see • Dr Carlos Lisa answers the questions of our patients about the care of their eyes
pág. 42 Gastronomy • Elite pourers
pág. 44 Crossing of glances • Jessica Chastain Table of contents
5
The Instituto Oftalmológico Fernández-Vega, case study in the IESE Business School of the Universidad de Navarra
The IESE Business School has chosen to use the Institute as an example of success in its classrooms. The two teachers who have developed the case, Alejandro Serrano and Philip G. Moscoso, have focused on the organisation of processes and on the practical application of the tools for continuous improvement used at the practice. Throughout the case one can see the direct impact of operational excellence both in the patients’ satisfaction and in the profitability of the centre. The case has a total of 20 pages and it will be translated into several languages as it will be taught in different countries.
Oviedo, headquarters of the II European Meeting of Young Ophthalmologists Approximately 300 professionals of the field from 27 different countries will attend.
Dr Rodríguez Uña and Dr Fernández-Vega Cueto-Felgueroso.
Oviedo will host the second European Meeting of Young Ophthalmologists that will be held in June 24 and 25 and which will gather approximately 300 professionals of the field coming from 27 different countries. The Spanish Society of Ophthalmology and its European counterpart have taken this decision by choosing the application submitted by
the Asociación de Jóvenes Oftalmólogos Españoles (AJOE – Spanish Association of Young Ophthalmologists) led by its president, Dr Fernández-Vega Cueto-Felgueroso, and Dr Ignacio Rodríguez Uña, vicepresident of the organising committee.
of the Spanish Society of Ophthalmology. Its focus is on the resident doctors of the specialty, acting as a contact forum to enable the inclusion of the youngest professionals in the ensemble of ophthalmologists of the country.
The Spanish Association of Young Ophthalmologists emerges in 2013 in order to support the teaching activities
The association is launched in 2013 aiming to supplement teaching activities.
Making headlines
7
Prof Luis Fernández‑Vega participates in the Forum of El Comercio on “Medicina e industria biosanitaria: oportunidad para Asturias” (Healthcare and Biosanitary Industry: opportunity for Asturias) The medical director of the Institute, Professor Luis Fernández-Vega participated last December 18th in the Forum organised by the newspaper El Comercio, in collaboration with the Sabadell Herrero Bank, on “Medicina e industria biosanitaria: oportunidad para Asturias” (Healthcare and Biosanitary Industry: opportunity for Asturias), together with the Minister of Health, Faustino Blanco, the president of the Medical College of Physicians of Asturias, Alejandro Braña; and the director of the Centro Europeo de Empresas e Innovación del Principado (CEEI), Eva Pando, with whom he analysed at the Abba-Playa Gijón Hotel the new niche markets offered by the health sector in the region. 8
Making headlines
Prof Fernández-Vega, during his intervention.
The Professor, who is also the president of the Spanish Society of Ophthalmology, provided an overview of the Institute from its origins, 125 years ago, to
the present, where nearly 200 this our home”, assured Prof professionals work in 12,000 Fernández‑Vega who, however, square meters attending over took the opportunity to call for 110,000 patients every year an improvement in “both air and performing approximately and railway” communications, 9,000 surgeries. These amounts to bet on the value of healthcare underscore the repercussion of as a business opportunity and the Institute, supported by the an economic driver. “Every time 50 million euros of benefit that a new airline is opened, the it generates number of patients each year for increases. This has attending over the region, as become obvious 110,000 patients is evident from with the flights to every year and the study carried Lisbon, which bring performing out in 2012 by us many patients approximately Universidad from Portugal”, he de Oviedo, stated. 9,000 surgeries. according to which 70% of The medical the patients who come to the director of the Institute also Naranco facilities do so from highlighted the need to bet on outside the Principality. advances and biomedicine, and reiterated that “today’s research “We have received many offers is tomorrow’s cure”; ”; he also to leave Asturias, several defended the collaboration that of them from investment according to him must exist funds, but we have always between public and private known that we should make healthcare.
The attendees to the Forum analysed the new horizons of the health sector.
Making headlines
9
The director and the deputy director of the Institute amongst the best physicians of the country The deputy director of the Institute, Dr Álvaro Fernández-Vega, was featured as one of the three best professionals in Spain in his specialty in the list published in Forbes magazine in December.
The prestigious publication, pioneer in the business field and with 26 editions all over the world, focused the last issue of 2014 to the field of health. It thus elaborated, in collaboration with the Corporate Reputation Business Monitor (MERCO in Spanish), a list of the best physicians in Spain, featuring three for each specialty; Dr Álvaro Fernández-Vega can be found amongst them.
The study in which Forbes relies is the first healthcare reputation monitor done in Spain and it includes the rankings of the best hospitals, both private and public, as well as the best hospital services and medical professionals according to specialty. In the field of ophthalmology, both the deputy director of the Institute and the director, Professor Luis Fernández-Vega,
Drs Luis and Álvaro Fernández-Vega.
were chosen amongst the five best professionals in Spain; the Institute is meanwhile placed amongst the first six positions in its specialty. The study, carried out by Análisis e Investigación -the first Spanish market research institute- and funded by MERCO, gathers the assessment of 1014 physicians, 745 nurses, 430 patient associations and 208 journalists.
Making headlines
11
The Institute hosts the XI Spanish National Conference of Health Informers The Instituto Oftalmológico Fernández-Vega will host next April 10, 11 and 12 the eleventh edition of the Conference on Health Journalism and Communication, which will gather in Oviedo scores of informers specialised in this field.
On this occasion, the Ebola virus outbreak will be the common thread to analyse the treatment of information both by the political and institutional arenas and by the media. There will also be a table on cheese and health, as well as a section devoted to analyse
10,11,12 APRIL
the health‑science-environment synergies. Established in 1994, the Spanish National Association of Health Informers organises an annual meeting to analyse and share professional practices.
Two moments of the last edition.
Update course in Glaucoma
24-25 APRIL
The Instituto Oftalmológico Fernández-Vega will host next April 24 and 25 an update course in Glaucoma, in which it will once more gather the ophthalmological community to share, during two days, the latest knowledge in the field. Headed by Dr Pedro Pablo Rodríguez Calvo this course is included within the continuous training program in Vision Sciences of Universidad de Oviedo.
12
Making headlines
Our physicians, in Facoelche 2015 A team of four physicians from the Institute visited this year Alicante to attend the first ophthalmology conference of the year: Facoelche. Together with the mayor of Elche, Mercedes Alonso, and the event organiser, Dr Soler, Prof Luis Fernández-Vega and Dr José F. Alfonso were part of the opening table of the event as presidents of the Spanish Society of Ophthalmology and the SECOIR.
Prof Fernández-Vega receives the award.
Furthermore, the host of the meeting recognised Prof Fernández-Vega for the “constant support given by the Instituto Fernández-Vega to this project over such a long period of time”. Amongst other interventions, Prof Fernández‑Vega gave the special lecture on “Selection of multifocal lenses according to biometric criteria”, and Dr Alfonso related at the meeting “La grada solidaria”, the national and international work carried out by the Fundación Fernández-Vega with disadvantaged groups. Drs Luis Fernández‑Vega Cueto-Felgueroso and Ignacio Rodríguez Uña also attended the conference.
Opening table of Facoelche 2015.
Making headlines
13
Experts gather at the Institute to analyse the latest news on cataract and presbyopia surgery The Instituto Oftalmológico Fernández-Vega hosted in November a meeting organised by ALCON that gathered leading experts to address the latest news in crystalline surgery, a field in which technological innovations have progressed significantly in the last years.
“Approximately 400,000 cataract surgeries are performed each year”. Some of the participants before the facilities of the Institue.
One of the reasons is that cataracts are the main cause of avoidable blindness in the world, affecting 18 million people and causing poor vision in several more millions. For this reason, 22 million cataract surgeries are performed each year, thus becoming one of the most common interventions in the world.
14
Making headlines
One of the most relevant technological innovations for the experts is, according to what they analysed during the meeting, the femtosecond laser, which has contributed to “ease the whole cataract surgery procedure, providing greater safety throughout the intervention, and thus minimising complications”, assured the director of the Institute and president of the Spanish Society of Ophthalmology, Professor Luis Fernández-Vega.
This statement was supported by the medical director of the Centro de Oftalmología Barraquer, Dr Rafael Barraquer, who summed up the great advances of cataract surgery “in two lines: physical therapy, with the major milestone of intraocular lens implantation, and the safety of the surgical intervention, linked to a progressive decrease in the size of the incisions and to the development of technology in surgical devices to remove cataracts. In both cases -he added- femtosecond laser has provided previously unknown accuracy and versatility”. Meanwhile, the Head of the Department of Ophthalmology at Hospital Universitario
Donostia and medical director or Begitek Clínicas Oftalmológicas, Dr Mendicute, stressed the importance of minimising the risk associated to the human factor, which helps to perform a higher number of procedures and to “solve extreme situations, as it enables access to intraocular structures with micrometric precision”. Professor Luis Fernández‑Vega explained that in the case of Spain, “approximately 400 000 cataract surgeries are performed each year” so the significance of these advances is crucial. On this matter, the medical director of Alcon in Spain and Portugal, Dr Xavier Puig, reiterated the
commitment of its company to keep working to provide professionals all its innovative capability “in order to develop the most state-of-the-art technology in the field of eye surgery”.
Christmas announcement of the Asociación Belenista de Oviedo “A realistic, resounding and positive song to hope”. This was Professor Luis Fernández-Vega’s wish for the Christmas announcement that he proclaimed for the Asociación Belenista de Oviedo at the end of last December. Because “this time of year and these times call for it”; “because it seems that there are dangers lurking, because nights are longer and thicker and because common sense is saying to all of us that it is best to have some than just a little or nothing at all”. These are times of “disappointment and confusion” in which, however, there “this time is still cause for hope, “as long as human of year and goodwill imposes these times itself, even to good reason”. call for it” The medical director of the Institute demonstrated his absolute trust in the power of Christmas, a time of the year that “arouses – even in the less passionate – such philanthropic and fraternal feelings that it is an honour to proclaim it”, he thanked. And he relied in the great ones. In Cervantes. In Palacio Valdés. In Giovanni Papini. In Philo of Alexandria. In Nicolas Chamfort. And in Jean Paul Sartre, greatest exponent of existentialism who, however, reflected in “Bariona” the hope brought by the Child of Bethlehem. “In this historical post-modernity that we are living in ‑culture of replacements, of theoretical and practical assertions on the death of God, of the decline of the values that laid the foundation of society‑ it is significant that, sometimes, we can observe in those who preach emptiness or nothingness surprising and paradoxical things that may be at odds with their ideas”, he stated.
16
Making headlines
Despite this, Professor Fernández-Vega believes that Christmas has no borders and that it’s a holiday for everyone. Likewise, it has much to do with his everyday life, he stated. “Our mission and profession is to bring light to tired or ill eyes, betting always on light and doing everything in our power to achieve it”. Photography: Miki López.
“Our mission and profession is to bring light to tired or ill eyes, betting always on light and doing everything in our power to achieve it”.
The king of Saudi Arabia at the Institute The new king of Saudi Arabia, Salman Bin Abdulaziz Al-Saud, visited the Institute in August 2006, suffering from a disease that was causing him progressive loss of vision.
The king with Luis and Álvaro Fernández-Vega at the Institute.
After consulting with the best specialists of the world, the then-Prince and governor of Riyadh came to the Instituto Oftalmológico Fernández-Vega following the recommendation of his friend the King Juan Carlos, where the medical director, Professor Luis Fernández‑Vega, treated him.
The channel OftalmologíaTV is born The Instituto Fernández-Vega, in collaboration with MedicinaTV has launched OftalmologíaTV, an educational project about ophthalmology that can already be found on the Internet.
Which has 40 videos on all types of pathologies, questions and advice in relation to eye health. The physicians form the Institute are in charge of explaining every week a new theme in an approximately two minutes long video that can be seen both in MedicinaTV and in the digital platforms of the Institute: Facebook, Twitter or its webpage.
www 18
Making headlines
The mobile application of the Institute, now in English too The app EyeVega is already bilingual. From now on, all patients and friends of the Instituto Oftalmológico Fernández-Vega will be able to benefit both in Spanish and in English from an app thought by and for patients; it gathers the most frequently asked questions by our patients, so that you can obtain your answers as quickly and as excitingly as possible.
Downloading the app EyeVega is completely free.
From EyeVega you can access the most relevant information on the Institute (location, medical team, history, etc.), as well as obtain an appointment. There is also an ophthalmological atlas where you may look up any query about the field of ophthalmology. Furthermore, a feature has been developed to enable, in game-mode, to check one’s vision with the most common eye exams. Downloading the app EyeVega is completely free of charge and is available both for IOS (iPhone, iPad) and Android, in telephones and tablets. And now, it is available in English too.
Making headlines
19
The Fundación Fernández-Vega checks the eyestrain of 400 people during the World Glaucoma Day On March 12 last, coinciding with the celebration of the World Glaucoma Day, the Fundación Fernández‑Vega set up a tent in the centre of Oviedo where they checked-up the eyestrain of over 400 people.
20
Making headlines
Drs Rodríguez Uña and Fernández-Vega Cueto-Felgueroso, during one of the check-ups on the Glaucoma World Day.
With this initiative the Foundation provides The Instituto Oftalmológico Fernández‑Vega, continuity to this activity, which has been carried through its Fundación de Investigación out for several years, aiming to make society Oftalmológica (Eye Research Foundation), devotes aware of the importance part of its resources to the of regular check-ups research of this disease. The Instituto for the early detection In fact, last 6th of March of a pathology already a team of the Institute Oftalmológico considered the second received, during the X Fernández‑Vega, cause of blindness in the Conference of the Spanish world. The fact that the Society of Glaucoma, an through its award for the scientific most common type of Fundación de paper “Comparative this disease presents no Investigación proteomic study in serum symptoms until it’s very of patients with primary advanced is the reason why Oftalmológica (Eye open-angle glaucoma over 50% of those affected Research Foundation), and pseudoexfoliation in developed countries and 90% in developing countries glaucoma”. Published last devotes part of its are unaware of having the year, it has obtained the third resources to the disease. THEA-SEG de Investigación research of this en Oftalmología 2014 Award Therefore, a team (Research in Ophthalmology) disease. constituted by Dr Ignacio for the best publications. Prof Fernández-Vega and Rodríguez Uña, Dr Pedro Pablo Rodríguez Calvo -amongst othersoptometrists Alberto Barros, Manuel Álvarez, were in charge of its presentation. Henar Morchón and Elena Alonso and secretaries Silvia Alonso and Carmen Miranda went on the Third THEA-SEG Award on World Glaucoma Day to the tent set up in the Research in Ophthalmology vicinity of the Teatro Campoamor, which was 2014 for the best visited by over 400 people that wanted to check their eyestrain quickly, easily and for free. publications.
Making headlines
21
La vida sin cataratas ...y sin astigmatismo. Hoy en día, existe una solución real a la hora de afrontar la cirugía de la catarata con astigmatismo. Las lentes intraoculares actuales permiten corregir el astigmatismo proporcionando una nítida visión a media y larga distancia sin necesidad de gafas. Su oftalmólogo le asesorará sobre las opciones disponibles.
©2014 Novartis Material revisado en marzo de 2014. SG/IOL/IOLGE/AD/140310/ES
The most + 2.0
The activity of the Institute on Social Networks is huge, and its followers are becoming more and more abundant. Through Facebook and Twitter we share the latest news on life at the Institute, at the Fundaci贸n Fern谩ndez-Vega and at the FIO, curiosities regarding ophthalmology and other related news in general. This is what our followers have liked the most since our last issue of Vega.
The most + 2.0
23
The Foundation in Cambodia Victoria Cueto‑Felgueroso Botas Director of the Fundación Fernández-Vega
Cambodia. Its name evokes a land full of Buddhist temples, sunny rice fields and exotic landscapes… And if we add to it the name Kike Figaredo everything changes and acquires another dimension. The magnanimity of his commitment, motivation brought about by humanitarian help. 24
Fundación Fernández-Vega
Enrique Figaredo and the team of the Fundación Fernández‑Vega. With them, “Sombrita”.
This was the purpose of the fifth “expedition” of the Fundación FernándezVega to Cambodia: to help by means of checking the eyesight of those in need at the Prefecture of Monsignor Kike Figaredo in Battambang.
The idea originated five years ago. The team was set up last October. It was constituted, on this occasion, by professor Fdez.-Vega Sanz, his son Luís Fdez.-Vega Cueto-Felgueroso, and the head of optometrists of the clinic, Javier Lozano. The trip took place in December, making use of the Inmaculada long weekend.
We were received with a surprise: a mass chanted and danced by the Cambodian children of the Ta‑Hem Parrish that we will never forget. The church flaunted right at the top the Cruz de la Victoria, so fully ours, so fully Asturian. Devotion was joined by the most sincere jubilation of each and every participant. Parrish of Ta-Hem, with the Cruz de la Victoria.
We were full of hope for this stimulating project and thankful for receiving the opportunity to take care of and help people without financial resources, many of them mutilated by anti-personnel mines. Priest Kike Figaredo has been fighting tirelessly for 30 years so that the Cambodian families who survived the dictatorship of the Khmer Rouge (1975-1980) can recover their lives and their dreams. We travelled loaded with suitcases full ophthalmological equipment, glasses with different prescriptions and drugs. Of course, in this luggage we couldn’t forget sweets and balloons for the kids, as science must be seasoned, from time to time, with some In this happiness. luggage we
couldn’t
We finally arrived, after 24 forget hours of never-ending flights, sweets and to Battambang, North‑East of Cambodia. The city balloons for impresses at first glance due the kids. to its abundant rice fields, peculiar trees and to landscapes characteristic of an impressionist painter.
And then it was time to perform the activity to which the Instituto Oftalmológico Fernández‑Vega had committed itself. Approximately 450 Cambodians attended the practice in those days of exhaustive work in which the team checked the patient’s eyesight, prescribed glasses and performed small surgeries to those in need. The workday started at eight in the morning and ended at seven at night, with an hour for lunch that sometimes turned into half an hour. And we can say, unanimously, that unforgettable human beings appeared before our eyes in that dispensary, individuals full of gratitude and gifted with a kindness and happiness that soon would translate into teaching and learning for each one of us.
Fundación Fernández-Vega
25
Luis Fernández-Vega Cueto-Felgueroso observing an eye fundus.
We won’t forget Toi, the boy who lost a leg to an anti‑personnel mine and who had his shrapnel scars examined by Professor Fdez.-Vega. His wheelchair is his most precious possession to move about.
I could name many unique characters from that Mission. Special people, as were the volunteers. Jimena Alonso, an Asturian in charge of the dispensary, poured her energy into helping us understand the needs of those people with Nor will her command we forget of the These young Sombrita, Cambodian nearly blind language. people put on and deafAlong with hold their mute, pickedher were degrees, their up by Kike Jaime Figaredo Rubio, Irene families and and, this year, Rehberger, their hobbies as happy as Lorenzo to provide a sandboy Zabala… because the All of them invaluable ophthalwonderful. support. mologists These young from Oviedo people put had brought on hold their her a pair of pink glasses that degrees, their families and their balanced out her 17 dioptres hobbies to provide invaluable of hyperopia. She was really support. This is also a privilege, excited holding Luis Fdez.‑Vega as the training and the human Jr.’s hand while he checked her value that they acquire while eyesight, she then held up her performing these activities isn’t hand in a sign of victory. easy to acquire.
26
Fundación Fernández-Vega
The days flew by. On the last day, the ophthalmological practice moved to the textile factory “La Paloma”. This is one of the latest projects of Monsieur Figaredo; over 60 individuals work making clothes that are subsequently exported to different countries. The Cambodians were thrilled to have a salary and a job that helped them support their families. Many of them were disabled, used wheelchairs and had poor eyesight, so they came to the improvised dispensary in a warehouse annexed to the factory to correct, cure or check their eyes. At the same time as we were running out of glasses, eye drops and other drugs -leaving their packages in improvised bins- our “addiction” to Kike’s Prefecture grew. So did our sadness, as we knew that our time there was drawing to an end and we had to come back.
I believe that whatever happens to us in life can either go unnoticed or, on the other hand, make an impression. If the latter are experiences that surprise us and transform us, they become -forever- unique and unforgettable experiences. That is how each and every one of the team members of this 5th expedition of the Instituto Fdez.-Vega that took place in December 2014 feels about it. I recall, to finish off, the words that Pericles pronounced in Ancient Greece and that can be applied to all types of aid provided to our fellow men. And these are: “use your knowledge, success and wealth as a means for action, not as something to boast about”. From Oviedo, we often return to Cambodia using our imagination. To Batambang and to Ta-hem… to the happy faces of children running and playing… to the generosity of Kike Figaredo and those who were helping him… to all those that had their eyes checked by the Fernández-Vega family and to those who were put on hold until next time. CHUM RI-ED LIE… Good-bye… See you soon… and thank you from the bottom of our hearts for your everlasting smile and for allowing us to get to know you.
Luis Fernández-Vega and his son greeting a patient.
“Use your knowledge, success and wealth as a means for action, not as something to boast about”. Javier Lozano doing a prescription.
Fundación Fernández-Vega
27
At the Asociación de Síndrome de Down de Asturias Last 16th of January, a team of the Fundación Fernández-Vega visited the Down Syndrome Association in Asturias to perform a total of 24 exhaustive eye check-ups. Drs Dagoberto Almanzar and Ignacio Rodríguez Uña and optometrists Pedro Estévez and Borja Martínez worked, together with the intensive collaboration of the workers of the Association and the families of the patients, till late at night; they especially detected high astigmatism. It was the first time that the Foundation worked with these patients; this collaboration is expected to continue in the future.
Eye examination at Residencial Balbona.
Dos momentos de la visita a la Asociación de Síndrome de Down.
Furthermore, on the 3rd of November los Drs Luis Fernández-Vega Cueto-Felgueroso, Dagoberto Almanzar and Ignacio Rodríguez Uña, together with optometrists Elena Alonso and Elena del Val and Abraham Álvarez, from the maintenance service, visited the care centre for the elderly Residencial Balbona, 10 minutes away from Oviedo, where they checked the eyes of 40 elderly people.
Fundación Fernández-Vega
29
Retinitis Pigmentosa, in the spotlight It is a rare disease that, currently, has no specific treatment. However, important lines of research are being developed. The Instituto Oftalmológico Fernández-Vega is involved in several of these lines.
Dr Álvaro Fernández-Vega.
30
Medical article/report
Retinitis pigmentosa is an inherited condition that can often cause cataracts at an early age, macular complications such as cystoid macular oedema or epiretinal membranes and even lead to blindness. Even though, unfortunately, this condition cannot be currently treated, it is possible to address many of its complications. Dr Álvaro Fernández-Vega, head of the Retina and Vitreous Department of the Institute, stressed this point last September 28 on the occasion of the International day of this disease; the Spanish Federation of Retinitis Pigmentosa Associations (FARPE in Spanish Federación de Asociaciones de Retinosis Pigmentaria de España) commemorated it under the slogan “Our dream is to see. Let’s boost research”.
Retinography of a retinitis Pigmentosa.
Indeed, it is research that has enabled the development of important strands work in different aspects of the pathology that may be useful in the medium term. The Institute is one of the centres actively working on this.
that only those patients whose external retina is completely damaged, i.e. completely blind patients (a small percentage of those who suffer from retinitis pigmentosa), are eligible for this treatment. Another line of research, based on cell transplants, is taking its first steps.
“In the specific case of our Eye Research Foundation 25,000 Spaniards affected (Fundación de Investigación Retinitis pigmentosa is the Oftalmológica - FIO), one of the most common cause of few private centres in Europe inherited retinal degeneration. devoted to ocular research, we It is characterised by an initial are working in the development peripheral vision loss that, in of neuroprotective measures some cases, can lead to vision to avoid the deterioration of similar to what one would see if certain cells of the retina. We one looked through the barrel of know that some stimuli, like the a shotgun and may finally lead blue component of sunlight, are to blindness. prejudicial for In Retinitis these cells and Retinitis pigmentosa, can foster the a progressive progression of pigmentosa destruction of the disease. At is the most some of the this point we research which common cause cells of the retina occurs, substances or of inherited leading to the which types of retinal progression of protection will prevent the degeneration. the disease. One of the initial deterioration symptoms is of the poor vision in dimly lit areas or retina”, explains Dr Álvaro low light conditions. Fernández-Vega. Furthermore, the Institute also researches the genetics of this disease and works in the treatment of retinitis pigmentosa through the implantation of an electronic device, or chip, in front of the retina. This chip takes over the function of those cells damaged by the disease and electronically stimulates live cells, generating a visual sensation of contrasts. With regard to the latter line of research, the doctor explains
It is estimated that this inherited degenerative disorder of the retina affects approximately 25,000 people in Spain, of which one quarter will progress to functional blindness. Even though the onset of this disease varies, the first symptoms usually appear in the second or third decade of life. The first symptom of this condition is usually night blindness, which is to say, a slow ability to adapt to darkness. Those affected have
difficulties in seeing at night or in dimly lit areas, and have difficulty distinguishing shapes and objects. They also find it difficult to calculate distances or catch objects in movement. Subsequently, they progressively loose their lateral visual field. The progression of this condition is slow and silent; patients wait an average of 15 years to go to the ophthalmologist since they feel the first symptoms of night blindness. It is not just one condition, but a group of chronic eye disorders of genetic origin and degenerative nature that are grouped under this name. It is occasionally associated to other diseases or syndromes, like hearing impairments, deafness, (USHER syndrome). “There are many types of retinitis pigmentosa, depending on the gene that affects its development, and therefore its evolution is always different; progression can also vary for different members of the same family affected by this hereditary disorder”, concludes Dr Fernández-Vega.
Medical article/report
31
Ametrine eyes A rough stone Bénédicte of ametrine -a Parnaudeau variety of quartz resulting from obtained the fusion of the second amethyst and prize in the citrine-, an idea category and a mixture of passions. These are “Sparkle”. the ingredients that Bénédicte Parnaudeau, patient at the Instituto Fernández-Vega, needed to design a masterpiece of jewellery worthy of the second prize in an international competition. Specifically, the IV Premio Antonio Negueruela, where she was a finalist with ‘El ojo del poeta’ (The Eye of the Poet), a piece that shows her experience as a gemmologist, her passion for designing jewels and her fascination with eyes.
“I believe that the eyes are the window to the soul. And not only in humans, I love animals. If one looks into the eyes of an elephant one can never doubt their intelligence, strength and tranquillity”, explains Bénédicte Parnaudeau, who underwent eye surgery at the Institute 2 years ago. “I had a rough ametrine
32
Art
stone and I thought of making a two-coloured eye, yellow and purple, taking advantage of the chromatic peculiarity of this gem, which is only found in one mine worldwide - in Bolivia. I loved it and I wanted to try and make an eye with it. It was quite a surprise to receive the second prize, so I told
Dr Alfonso, who was the one to operate on me”.
With the “El ojo del poeta” she has obtained recognition, but it is not the first piece nor will it be the last. She will combine her training as a gemmologist and her work as a teacher assistant at the Instituto Gemológico Español with the design and manufacture of jewels, in which allusions to eyes do not go amiss. The Antonio Negueruela awards aim to pay tribute to the pioneer in the marketing and distribution of coloured gems in Spain and in honing the renovation of jewellery design and the dissemination of knowledge and
“I believe that the eyes are the window to the soul. And not only in humans, I love animals. If one looks into the eyes of an elephant one can never doubt their intelligence, strength and tranquillity”. charm of this type of stones. Bénédicte Parnaudeau obtained the second prize in the category “Sparkle”, which rewards design and the size of the coloured
gems according to the difficulty, perfection in the execution, originality and use of the optical properties of the material.
The
importance
of a smile
They are barely seen in the corridors where the physicians’ offices are, unless as a first contact to those who have suffered some kind of accident and usually come through an insurance company, just before they see their ophthalmologist. However, they are present, putting their know-how and their smiles at the service of the surgeon and the patient. The team of nurses of the Instituto Oftalmológico Fernández-Vega spends half its time at the operating theatre. They provide assistance to surgeons and show a friendly face to all those who put the health of their eyes in our hands. A friendly face and simple words - accessible to all. “Sometimes patients are nervous when they come out of the surgeon’s office, they get to the operating theatre and ask the same questions they’ve already had answered by the surgeon. It is not about repeating things, it is about make things easier. It is also with us with whom they speak after the surgery. And in the next day’s follow-up. We also carry out an intermediation activity of some sort between the ophthalmological jargon and common language, something that is more notable with nerves”. Avelino Ojanguren has been with the department for 14 years. So many years, that when
34
Our departments, one by one
the now coordinator of the Nursing Department came to the Institute the team was constituted by three nurses who just needed operating theatre courses. Things have changed a lot since then. There are now eleven professionals in the workforce; which also includes Raquel Ramos in the facilities in Madrid and two more from the Masters in Ophthalmic Nursing – a Masters that has been carried out for the last four years at the Institute in collaboration with the Universidad de Oviedo. Technology, IT, lasers, etc. have also changed; and the appropriate specific training is both vital and difficult to obtain. That is the reason why the Institute is now offering this training. “Every year we choose two nurses who are in agreement with Universidad de Oviedo and we train them for nine months; thus, in the last two months we already know if they know how to do what is needed. For example, this has enabled María Every year we García Villamil -who choose two was a student of the nurses who are Masters last year- to in agreement cover the maternity leave of a co-worker, with María Requejo. We Universidad de had trained her Oviedo and we ourselves, so it was train them for perfect”, explains Ojanguren. nine months. Natalia González is studying the Masters this year. When she came for the first time to the Institute back in October she didn’t know much about eyes, but this didn’t last for long. “This is a world benchmark centre and we – students - get to see all areas, so I’m very happy. Furthermore, we get to see the patient from the moment he
“One comes happy to work”.
Looking out for the dream of our patients comes in until he leaves; there is a close and friendly relationship with the patient”, states this young woman who highlights the “remarkable atmosphere” found at the department. The whole team agrees on this. Elena Gónzalez, who has been with the department for 10 years now, summarises it with: “One comes happy to work. If one wants a chilled job, this is not the best option, but it is a beautiful job, where everything moves along and in which you have to keep updating yourself all the time. The Institute facilitates this, but one has to want to keep training, to keep learning”, she explains. Because nearly all of them do everything: operating theatre, anterior pole, cataracts, preparing the instruments and the patients, Lasik… One has to be up-to-date. “If I had to choose, I would probably choose Lasik, but I really love everything I do”, reflects Tamara Fernández. She has worked in all areas during her eight years at the Institute. Treating myopia, hyperopia or astigmatism on an outpatient basis, explaining to patients what they have to do when they get home, discharging patients, handing medical equipment to the physicians, being a circulating nurse… “There are many options, and I love them all”. And even though they all agree that one has to be able to tolerate stress to be able to do this job, know how to prioritise and have very clear ideas, it is worth the effort. Specially when you remove the eye bandage and a patient is moved because he is able to see again. Adriana Gómez knows this first hand, and she claims that the moment cannot be any more restorative. Especially if one can share the moment, and this isn’t a problem at the department. The best thing is the environment. The teamwork. The bond between co-workers. “We work to achieve this, because a good working environment is paramount to everyone: to the patients, to the staff, to the Institute… Strengthening the good points makes us work better and, at the end of the day, the aim is to provide the best service to the patient both early in the day and late in the afternoon”, affirms Ojanguren.
When the night comes and her co-workers leave the centre, Vanesa Aller comes through the doors of the Institute to start her working day. She is the nurse in charge of the night shift, she who stays with those patients that for one reason or another need to stay hospitalised and she who makes the patients’ health and safety her priority. She is the most seasoned member of the department. She will have been at the Institute for fifteen years this summer; she came at a time when there were only three nurses and when there was no hospital pharmacy at the centre. “The Institute has progressed a lot in these last fifteen years: the amount of patients, the team and the way of addressing eye diseases with new technologies. Even the way in which drugs are managed at the ward has changed a lot in the last few years; this change has been brought by the changes in the pharmacology market and in post-operative treatments. Thus, it is paramount that we receive constant training”, explains Vanesa. Applying post-op treatments, patients’ chronic diseases, providing drugs, cures, clarifications, explanations, encouragement and advice… She has multiple and varied tasks, mainly because they combine the treatment of eye pathologies with the most human side, that of the fears or the nerves of the patients as well as their circumstances. However, at the end of the day her mission can be described in a few words: “to look out for the patients since the moment they are admitted in the unit till they are discharged with the seal of quality so characteristic of the Instituto Oftalmológico Fernández-Vega”.
Our departments, one by one
35
Jesús Merayo Lloves, Professor of Ophthalmology at the Universidad de Oviedo and head of Research at the Fundación de Investigación Oftalmológica of the Instituto Oftalmológico Fernández‑Vega.
Should one invest in basic and translational research? What does private research contribute to companies? Is it worth it? Dr Jesús Merayo, principal investigator at FIO, has recently analysed this issue for the Health journal of El Economista in an article that we summarise below. The activity of the Fundación de Investigación Oftlamológica (FIO – Eye Research Foundation), a private entity devoted to the study of the basis of the diseases that compromise vision, began in 2009. Its aim is to provide results as soon as possible to the medical and surgical activity of the ophthalmologists. Ever since, and in only five years,
36
Research
over 40 research projects have been published, two patents have been obtained and it has helped patients gain access to two products that have been launched to the market. One of them is a prosthesis that prevents patients with certain pathologies from undergoing corneal transplant; the other is a regenerative eye-drop that only in the Instituto Oftalmológico Fernández Vega (IOFV) benefits 800 patients every year. Moreover, teaching activities have been consolidated through eight highspecialisation training programs for professionals in the fields of ophthalmology and vision sciences, a program of on-going training and a system for the training of researchers. All this thanks to the working relationship between basic, translational and clinical researchers, the research and teaching framework agreement with Universidad de Oviedo and its relationship with the biotechnological environment.
The relationship between basic, translational and clinical researchers enables the transfer of the day-to-day problems of the practice to the lab and the discoveries of the lab to the practice. But, how does this benefit the company that has directly promoted the FIO? In several ways. On the one hand, the Institute returns to society part of what society has given to the Institute, guaranteeing excellent prevention and medical and surgical care thanks to the constant innovation and to the transfer of the results of research and on窶組oing training.
On the other hand, having ophthalmologists, optometrists, nurses, mathematical biologists and vocational students working with us enables us to know, select and subsequently offer the best of them the opportunity to become part of our team, thus guaranteeing the generational renewal of the institution. This also enables us to have former students in different centres throughout Spain that see us as a benchmark hospital where one can give solutions to patients with complex problems. Then, is private investigation within companies worth it? Absolutely. To offer new products for the same market, to open new markets, to channel internal entrepreneurs... Through different synergies with the immediate entourage, companies will, undoubtedly, profit from short and mid-term direct and indirect benefits.
Research
37
“I don’t like <everything’s ok>, but <everything can be better>” Luis del Olmo, journalist. Luis del Olmo (Ponferrada, 1937) faced a microphone for the first time during his youth. Ever since, his voice has informed us of the most relevant global events, has introduced us to people who have changed the course of History and has showed us, with his sharp analytical eye, to see the background of each event. We’ll do a short review of his career, his concerns, of how he - who has done over 12000 programmes and has deservedly earned the title of everlasting leader of the Spanish radio - sees the past, the present and the future.
“If we have got this far is because we worked non-stop and we armed ourselves with patience”. 38
They look kindly upon us
Have you always wanted to work in radio? As I was born in mined land, I studied to become a mining engineer, but I begun to perform interviews for the broadcasting station in Ponferrada and I understood that that was what I actually loved. I remember going to the station looking for celebrities that travelled in the train from Madrid to Galicia to ask them some questions, the satisfaction that I felt when I subsequently heard them in the radio made me abandon everything else. Which has been the hardest interview? Maybe the last one I did to Santiago Carrillo. He wasn’t in a very good frame of mind that day, and when I asked him about the Paracuellos issue, instead of answering like on other occasions, he sent me to Hell. The sentence didn’t make a good impression when heard on the radio. Who would you like to interview over and over again? Queen Sofia, without a trace of doubt. I’ve spoken briefly to her on the radio, but I still wish I were able to conduct an indepth interview. As a personality she is interesting; as a person she is exemplary.
“I still wish I were able to conduct an in-depth interview to Queen Sofia”.
Which is your favourite historical event? For me, the greatest moment for the radio and in our lives was the day we voted the Constitution. We can say that that day was the debut of democracy.
“The greatest moment for the radio and in our lives was the day we voted the Constitution”. Of the many awards that you have received, which is your favourite? The recognition of the university. I’ve always said that the radio is the university of the people; so I considered it an honour and a privilege when the Universidad Rey Juan Carlos awarded me a doctorate “honoris causa”. Now that you are retired, what do you do with your free time? I’ve got many things to do. I spend my time addressing conferences on my life at the radio, traveling and chatting with my nine grandchildren. Do you have any challenges lying ahead? Yes, to live. What would be your advice for the new generations that want to follow in your footsteps? To copy my generation. If we have got this far is because we worked non-stop and we armed ourselves with patience. The radio means work, work, and
work; and lots of patience to await an opportunity. Which adjective describes you best? I don’t like “everything’s ok”, but “everything can be better”. A film. “Ocho apellidos vascos” (English: Eight Basque Surnames). A simple film, without ambition but very effective. A book “Love in the Time of Cholera”. A great novel. An actor or actress Verónica Forqué. A singer Serrat. Always Serrat. An aothor Gabriel García Márquez. How do you see Spain in 2015 in relation to communication? Given what is happening, this looks like a soap opera, with an unexpected ending. Maybe even a surprising ending. Being from El Bierzo, what relationship do you have with Asturias? A very strong one. I’m half Asturian. My dad was born in Avilés. My first professional broadcasting station was Radio Asturias. I’ve attended and broadcasted all 33 years of the Prince of Asturias Awards. And with the ophthalmologists Fernández-Vega? I’ve always had a close friendship with the Fernández-Vega family. For me it is a real luxury.
They look kindly upon us
39
Dr Carlos Lisa answers the questions of our patients about the care of their eyes Dr Carlos Lisa
I’m 33 years old and I’ve been having frequent headaches for a while now, especially at the end of the day. At the beginning it was enough to take drugs such as Ibuprofen, but currently I cannot ease the pain and it only goes away if I lie down in bed and switch off the light. Can this be related to my sight? My physician has advised me to visit an ophthalmologist although I’ve always had a good near and far-sighted vision.
40
Lets see
There is a disease named accommodative asthenopia characterised by periocular headaches sometimes associated with blurred vision. It is usually related to the overuse of near vision (prolonged reading, an excessive use of computers…) and it’s common in patients with hyperopia or with insufficient convergence. The problem is that the ciliary muscle responsible for accommodation and near vision is being overstrained and this translates into a headache particularly at the end of the day. In your case it would be advisable to get examined under cycloplegia to rule out latent hyperopia.
The last few years I’ve suffered from recurrent ulcers associated to an excessive use of contact lenses. I am currently 29 years old and my 4 dioptres of myopia have not increased since I was 26 years old. During a follow-up I was told that my cornea is too thin and that therefore I cannot undergo laser surgery. Are there any other options that enable me to avoid the use of contact lenses and glasses? How can I improve my tolerance to contact lenses? Recurrent ulcers in patients who wear contact lenses tells us that contact lenses are being overused or that there us an underlying disease (blepharitis, dry eye…) that advises against its use. In these cases in which laser surgery is not indicated there is the option of correcting myopia through the implantation of a phakic intraocular lens (IOL) that would be placed in front of the crystalline and behind the iris. This technique is also used in young patients with high myopia that want to avoid using glasses and/or contact lenses.
I’m 45 years old, and ever since I was 25 my astigmatism has been increasing and my vision has worsened. My ophthalmologist has said that my cornea is irregular and that I must come back for a follow-up in six months because I might have a corneal disease. What worries me the most is the possibility of my two children -13 and 15 years oldinheriting it. Is this common? Taking into account what you’ve told us it looks like you have Keratoconus, a disease that causes progressive deformity of the cornea and generally presents itself at 15-20 years of age. The latest studies show that between 10 – 20% of patients with keratoconus has family a history of the disorder. Regardless of its low prevalence, it would be advisable to have your children’s eyes checked by an ophthalmologist, as nowadays we have measuring instruments that allow us to make an early diagnosis of the disease and to be more efficient in its prevention and potential treatment.
Elite pourers I globetrotted a lot throughout Western Europe when I was young. I drunk several beers in England, Ireland, Belgium, Germany and communist Czechoslovakia: I didn’t count them, but they weren’t few, although back then they didn’t manage to increase my volume. I’ve had in front of me many ‘pint glasses’ (typical pint glasses from Irish pubs), mugs, ‘steins’ (those insufferable decorated ceramic mugs used in Germany), flutes and glasses with the golden and bubbly drink, so I thus believe that I know what I’m talking about.
42
Gastronomy
In all those places they at least know how to pour beer: an art that most certainly needs some practice and knowledge, but that first and foremost requires tranquillity. And I believe that Europeans, at least those from the 45th parallel to the North, are (myself through adoption) mainly calm. Therefore, a glass of beer in any of these countries requires some time from the moment it’s ordered until it’s served at the table. The client knows and the pourer knows; that is why at least a good fifteen minutes can go by until one moistens one’s lips in its foam. And foam is what it’s all about, an integral part of every self-respecting beer: beer either reaches the mouth through a generous head of foam or it is best if it doesn’t reach at all. An expert in the subject once told me: “beer requires its time to be poured, but also to be drunk. If one takes too long to pour it, it looses properties. The same thing happens if one takes too long to drink it”. It is also important to know how to drink it: if it is prolonged in time, half its charms are lost. The best seems to be to devote five minutes to pour it, one of the reasons being to avoid receiving a beer with too much carbon dioxide, which would fill us up and cause the associated burps. I believe that a good beer must be served with a head of foam of two fingers to the edge of the glass and an extra finger on top of it, so that when one takes the first sip one gets a “moustache”. The foam must be dense, in such a way that, as I was once told in Barcelona, it can hold on its surface a small coin without it sinking.
“Beer requires its time to be poured, but also to be drunk. If one takes too long to pour it, it looses properties. The same thing happens if one takes too long to drink it”.
It is true that, as one is drinking, the size of the foam decreases, but one thing is to decrease and another one to disappear - a big difference. And it must leave the ridges of every sip, the impression of the previous level in the inner side of the glass, what experts call Brussels lace. Ever since I saw -before I drunk- my first Águila Negra in Asturias I can guarantee that I haven’t found over half a dozen establishments where they knew how to pour beer adequately. It is understandable that when a pourer has in front of him a long line of consumers who are going to enter a show or something similar he cannot be too tactful. But there is no excuse whatsoever when one is chilling in a bar or pub that isn’t overtaken by the clientele. Madrid, Levante or Catalonia aren’t lacking in establishments with experience and professionalism, but I am perfectly happy to say that in this area this is a pending business, and one that must be addressed as soon as possible by sticking to the bar. However, we must be
pleased with ourselves as in the last few years, when the brewing of beer had fully ceased in the Principality, some young and not so young brewers have decided to be brave and resume an ancient activity that had begun in the council of Valdés La Luarquesa, in 1878. Small -scale brewing- what the English call home-brewing- is not excessively difficult or expensive, although it needs courage: it is what those who are establishing brands such as Caleya, Mayuca, Cotoya, Vorágine, Noega or Deva amongst others, are doing. Of course, these cannot yet be found in the supermarket or in the local bar. Let us hope that one day in the not too distant future it will be possible.
Eduardo Méndez Riestra Member of the Colegio de Críticos Gastronómicos de Asturias (Association of Gastronomic Critics of Asturias)
Jessica Chastain In his most recent book (The balcony in Winter), Luis Landero talks about the time in which he nearly danced with Sara Montiel. It was back in the 60’s and Landero was the guitarist of the flamenco troupe that entertained the many Spanish artists gathered in the film festival in Moscow. Landero says that, driven by the euphoria of the end of the festival, and seeing the one and only Sara Montiel come into the busy room, the troupe betted on who would dare ask her to dance. Among jokes and truths it didn’t come to anything. But Landero, who wasn’t a very daring young man, understood that he would not have another opportunity like that one, he therefore went up to the diva and, with his best manners, requested the next dance. I will not explain in detail, due to the deficiency of my prose, the gesture that Montiel gave the dandy. Landero still remembers the embarrassment and the sympathetic stares that walked him out of the dance floor. Of course, so long after, he can still proudly talk about that evening in Moscow in which he nearly danced with Sara Montiel. Over recent months, the worthy Management of this journal has been filling my dancing card with the most seductive partners, and I’ve dared dance with all of them. I’ve stepped on some toes, not to mention those times in which I’ve lost all sense of rhythm, but I believe that I’ve been able to perform some graceful pirouettes, always -it must be saidthanks to the singular talent of my companions.
When Jessica Chastain came in I stopped mid way, I wouldn’t dare start dancing. With Basque ancestors, a former Julliard student, a convinced vegan and, of course, a vocational redhead.
44
Crossing of glances
Winner of a Golden Globe, candidate to an Oscar, muse of perfumeries and owner of a dog with three legs. It is said that, at 38, she still has a lot to offer to the cinema. Well, this is all I can say about her. The Goddess didn’t have to look the penman with contempt: I didn’t have the courage to ask her to dance. I will have to do the same as Landero (and this is the second part of the story): when Sara brushed him off, he audaciously made up that Sofía Loren came in through the other door of the room, and that the Italian agreed to dance with him. This was the fabulous version he spread when he came back to Spain. I will make up that I yielded my unsuccessful dance with Jessica Chastain to Julianne Moore. But it will be best if tell you about this in another issue. Pachi Poncela.