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array:24 [ "pii" => "S2173578616300166" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2016.03.005" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "820" "copyright" => "AEU" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:317-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480615002636" "issn" => "02104806" "doi" => "10.1016/j.acuro.2015.11.005" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "820" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:317-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 78 "formatos" => array:2 [ "HTML" => 64 "PDF" => 14 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "El martirio de San Zoilo, una cuestión urológica. Historia y desarrollo de su tradición" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "317" "paginaFinal" => "321" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The martyrdom of St. Zoilus, a urological issue. History and development of the tradition" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1485 "Ancho" => 990 "Tamanyo" => 396524 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Imagen del Martirio de San Zoilo. Capilla de la Antigua de Nuestra Señora de la Concepción, de la Catedral de Córdoba.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Domínguez-Freire" "autores" => array:1 [ 0 => array:2 [ "nombre" => "F." 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The difference between the score of the test and retest (difference) is graphically represented against the mean of the test–retest (mean) for each patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Puche-Sanz, D. Martín-Way, J. Flores-Martín, M. Expósito-Ruiz, J. Vicente-Prados, M. Nogueras-Ocaña, J. Tinaut-Ranera, J.M. Cózar-Olmo" "autores" => array:8 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Puche-Sanz" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Martín-Way" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Flores-Martín" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Expósito-Ruiz" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Vicente-Prados" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Nogueras-Ocaña" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Tinaut-Ranera" ] 7 => array:2 [ "nombre" => "J.M." "apellidos" => "Cózar-Olmo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480616000085" "doi" => "10.1016/j.acuro.2016.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616000085?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300154?idApp=UINPBA00004N" "url" => "/21735786/0000004000000005/v1_201605260128/S2173578616300154/v1_201605260128/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173578616300178" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2016.03.006" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "839" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:309-16" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "The relationship between the sensation of incomplete voiding and a high postvoid residual volume" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "309" "paginaFinal" => "316" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La relación entre la sensación de vaciado incompleto y un residuo posmiccional elevado" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.A. Cayetano-Alcaraz, J.O. Herrera-Cáceres, A. García-Mora" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A.A." "apellidos" => "Cayetano-Alcaraz" ] 1 => array:2 [ "nombre" => "J.O." "apellidos" => "Herrera-Cáceres" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "García-Mora" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480616000097" "doi" => "10.1016/j.acuro.2016.01.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616000097?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300178?idApp=UINPBA00004N" "url" => "/21735786/0000004000000005/v1_201605260128/S2173578616300178/v1_201605260128/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "The martyrdom of St. Zoilus, a urological issue. History and development of the tradition" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "317" "paginaFinal" => "321" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "F. Domínguez-Freire" "autores" => array:1 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Domínguez-Freire" "email" => array:1 [ 0 => "freiredos@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Urología, Hospital Comarcal do Salnés, Villagarcía de Arosa, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El martirio de San Zoilo, una cuestión urológica. Historia y desarrollo de su tradición" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 741 "Ancho" => 992 "Tamanyo" => 131889 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Picture detail of the Iglesia de la Magdalena in the monastery of San Zoilo de Carrión de los Condes (Palencia).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The veneration of saints plays an important role in the tradition of the Christian religion, which can sometimes behave as “intercessors” to advocate for different diseases or symptoms, and possibly even cure disease. The number of saints based on ancient traditions is invoked in diseases of men and animals which is very abundant, being born by direct analogy with the kind of martyrdom of the saint in question, such as pulling teeth (Saint Apollonia), eyes (Saint Lucia), breasts (Saint Agatha) or kidneys, as in the case at hand: Saint Zoilus.</p><p id="par0010" class="elsevierStylePara elsevierViewall">According to the <span class="elsevierStyleItalic">Acts of the Martyrdom of Saint Zoilus</span>,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> Zoilus was a young Cordovan from a wealthy family who continually showed his beliefs publicly against the Roman law. Zoilus and 20 companions were accused of <span class="elsevierStyleItalic">superstitione christianitatis</span> in 304, which led to his arrest, trial, and death sentence. Previously, because of its significance, he was tortured “opening him in the back and extracting the kidneys”, despite which “he did not die being the Dacian, a perfect Roman of the IV century whose head is cut”.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The study of the iconography found in the martyrdom of this Saint in the 16th century on renal manipulation through different lumbar, thoracic, or abdominal incisions can show what could be the first pictorial representations of a nephrectomy.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In addition to highlighting, for its urological interest, the martyrdom of Saint Zoilus, narrative myth makes it possible to develop the tradition of the dedication and worship of the Saint, and describe the historical basis of it, aim proposed by the author in carrying out the study.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The study of the iconography found on the martyrdom of Saint Zoilus, 3 frames in different churches, where the removal of the kidneys is represented during the holy martyrdom.</p><p id="par0030" class="elsevierStylePara elsevierViewall">A detailed review of the history and tradition of this can be seen through literature, iconography, and oral tradition.</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the exhibition of the martyrdom of the saint we consulted:</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Martyrologium Romanum cum notationibus Baronii</span> by cardinal Baronius, published in Rome in 1586.</p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Valerio of scholastic stories</span> Title 3, Chapter 5, published in 1462, by Diego Rodriguez de Almela (1426–1489), archpriest of Murcia.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Volume II of <span class="elsevierStyleItalic">The Golden Legend for each day of the year: lives of all the saints who venerate the Church: work that contains all the “improved and expanded Ribadeneira” … work necessary for the spiritual nourishment of the faithful who yearn to know the circumstances of the life and virtues of their masters, and parish priests in order to know the names that can accept at the baptismal font</span>, published in 1853, which includes all other written references to the saint as:</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Liber peristephanon</span> by Prudentius (348–410), in his hymn <span class="elsevierStyleSmallCaps">iv</span>.</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Memoriale sanctorum</span>, Book 2, ch. 6 (856), by Saint Eulogius of Córdoba bishop of Toledo.</p><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Martyrology</span> (870), by Usuard, a Benedictine monk of the Abbey of Saint-Germain-des-Prés, from whom the remaining versions come.</p><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Martyrology</span> (872), by Adon bishop of Vienna.</p><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Martyrology</span> of Pedro Valeriano, published in 1578.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Saint Zoilus is also quoted by the Benedictine monk Venerable Bede in his <span class="elsevierStyleItalic">Ecclesiastical History of the English People</span> (731) and the <span class="elsevierStyleItalic">Toledo Breviary</span> among other works.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">The iconography found supports in the popular tradition and confirms that if Saint Zolius was tortured by having the kidneys extracted, it could be the first pictorial representation of a nephrectomy.</p><p id="par0090" class="elsevierStylePara elsevierViewall">We found 3 frames in churches that represent different populations. In the sacristy of Magdalene Church of Saint Zoilus monastery in Carrión de los Condes (Palencia), in the altarpiece of the Old Chapel of Nuestra Señora de la Concepción (Our Lady of the (Immaculate) Conception) in the Cathedral of Córdoba, and in the altarpiece of the church of Saint Nicholas of Plasencia. In the 3 canvases, according to the images, the backchannel as “approach” is used for the incision, this being done through the spine in the case of Córdoba and lumbar or subcostal in Carrión and Plasencia.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The painting of the sacristy of the Monastery of Carrion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) by an anonymous author is an oil on canvas that has been dated to the last quarter of the 16th century. It depicts a scene of the martyrdom of Saint Zoilus with Roman characters in accordance with history and tradition. The martyr is prostrated on his side and it can be seen how the person in charge of martyrdom introduces his right hand into the incision in order to remove the kidney. License of the artist is the presence in his left hand of which it seems the contralateral kidney has been drawn.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The painting of the Cathedral of Cordoba (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) has been dated to the 16th century and is the work of the painter Miguel Ruiz de Espinosa. Painting on wood is part of a Renaissance altarpiece located on the front of the chapel “Antigua de Nuestra Señora de la Concepción.” The scene depicts the torment of the saint; in it the person in charge makes a half incision over the spine prior to kidney removal.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The third image corresponds to the painting by an unknown author, the Renaissance altarpiece of the 16th century found in the church of Saint Nicholas de Plasencia (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). It is the most interesting incision from an anatomical point of view. The removal of the kidney can be appreciated with perirenal fat and traction of the ureter by the person in charge of martyrdom.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Drawn from reading literature sources, we collect the description of martyrdom literally from <span class="elsevierStyleItalic">Acts of Martyrdom</span> and <span class="elsevierStyleItalic">the Golden Legend for each day of the year …</span></p><p id="par0115" class="elsevierStylePara elsevierViewall">”… A young man of illustrious family who publicly expressed his Christian zeal. Denounced before the judge, the judge considered him as the most qualified among other detainees, so he tried to make him apostatize so that his example could drag the others …</p><p id="par0120" class="elsevierStylePara elsevierViewall">… As he was illustrious, if he waved in faith and sacrificed to idols he would influence many people with the example …”.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The description of martyrdom is completed with pious phrases repeated by different sources consulted: “… The judge who martyred him by ordering him to be whipped and teared with iron hooks, while the martyr snapped him “The more you mistreat my body you have now in your possession, the more my true good grows that does not fear your tortures” …</p><p id="par0130" class="elsevierStylePara elsevierViewall">… Then he made “open the saint in the back and gouged the kidneys” and enraged he drew his sword from its sheath and cut off his head and sent to bury the body between the burial of pilgrims and foreigners so that he could not be recognized.”</p><p id="par0135" class="elsevierStylePara elsevierViewall">Thus, the legend of this Cordovan martyr and his relationship with kidney disease, along with that of Saint Liborius, bishop of Le Mans in France, during the middle of the 4th century is created. He has been attributed with a “healing power” against urinary calculi since the end of the 15th century, <span class="elsevierStyleItalic">Attorney of ijada pains, kidney stones and urinary retension (sic)</span>.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">A third lawyer of kidney pain exists, Blessed Lesmes, but the differential diagnosis established confirms this pain is not of urologic origin. Blessed Lesmes, who died in 1218, whose remains are in the chapel of San Juan de Sahagún of the Cathedral of Burgos, should not be confused with Saint Lesmes (? -1097), a priest of French origin, patron saint of the city of Burgos and buried in the church of the same name.</p><p id="par0145" class="elsevierStylePara elsevierViewall">The third protagonist, faithful servant and charitable page of Saint Julian, second bishop of Cuenca (1128–1208), accompanied him on his apostolic work during the 13th century.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> In his pilgrimage, he devoted himself to making wicker baskets which he loaded with wheat and other foods to distribute among the poor. He had so much work with loading the baskets that he ended up with lumbar musculoskeletal problems. Because of this, he is invoked by those suffering from bone problems, back pain, and kidney pain. The people, seeking remedy for these illnesses, would rub or scrub the back on his grave.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">Of the first martyrs of Christianity, only some data are known by history, especially through tradition. We look back at the time already in decline of the Roman Empire when the Emperor Diocletian (284–305) tried the religious reunification.</p><p id="par0155" class="elsevierStylePara elsevierViewall">The earliest reference that exists of Zoilus is in the Hymn <span class="elsevierStyleSmallCaps">IV</span> of <span class="elsevierStyleItalic">Liber Peristephanon</span> by the Spanish Aurelius Prudentius (348–410), which relates to almost 30 martyrs. Most of them are Spaniards: <span class="elsevierStyleItalic">Corduba Acisclum Dabit, et Zoellum</span>.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Later in the year 613, a Visigoth nobleman called Agapius or Agapetus <span class="elsevierStyleSmallCaps">ii</span> was elected bishop of Cordova (614–618) during the reign of Sisebuto (612–621). They tell how he had a revealing dream of where the remains of Zoilus and his colleagues were.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> They recovered their remains and took them to the church of San Felix, which was called Saint Zoilus since then. They would be removed centuries later by Count/infant Fernan Carrion in 1070 to Carrión de los Condes in Palencia, the current location of the remains.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">The Cordovan people generally accepted the miraculous nature of the relics and thus it is regarded by believers as the “protector” patron of various ailments, especially those affecting the kidneys. In Córdoba today, remains a street called Saint Zoilus with houses where according to tradition the saint lived. The veneration of the so-called “well of Saint Zoilus” whose waters are attributed “miraculous” cures of kidney ailments remains because according to popular belief this is the well were “they threw the kidneys of the martyr” after the ordeal.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Between the date of the martyrdom of Saint Zoilus in the <span class="elsevierStyleSmallCaps">4</span>th century and the time of creation of the iconography was found in which this martyrdom represented, 16th century, the state of surgery barely changed. However, scientific studies progressed remarkably during the Renaissance, through the prism of humanistic philosophy. This knowledge was the engine of change in medical science in general, and in surgery and anatomy in particular.</p><p id="par0175" class="elsevierStylePara elsevierViewall">In the late Middle Ages, the ecclesiastical prohibition begins to become more flexible to dissect human bodies, doctors of the time timidly began to introduce themselves in the anatomical knowledge. One cannot understand the progress of anatomy and surgery without taking into account humanistic concepts that guided the footsteps of the Renaissance thinkers, among them artists, whose concerns were a key driver of change.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">The surgery was developed very slowly, although surgeons had neither knowledge nor adequate means to control pain and bleeding nor to fight infection. This limited the nature of the procedures that could be performed.</p><p id="par0185" class="elsevierStylePara elsevierViewall">There are references to incisions to perform surgical treatments for kidney disease from the 15th century, but not nephrectomies. Renal operations were limited to debridement of perinephric abscesses and wound exploration in the lumbar region.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Julián Gutiérrez de Toledo (born in the second half of the 15th century, date unknown), in his book <span class="elsevierStyleItalic">Healing stone and yjada pain and renal colic</span>, cites the access used in the known surgery about the removal of the kidney stones “… they are some who work removing the stone opening it through yjada or from behind on the back, but it is of great fear…”.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Cardan of Milan (1501–1576) relates an intervention in a kidney in 1505 in which he drew a lumbar abscess and found 18 stones.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Until the 19th century, kidney disease operations do not change, but with the discovery and implementation of anesthesia in 1846 surgery horizons expand. The possibility of interventions on the kidney is then discussed. The main fear of the surgeons was the control of renal pedicle, so before conducting a nephrectomy in humans, it was performed on animals. However, some general surgeons, in the course of abdominal operations transperitoneally, and due to a mistake in their diagnosis, they had removed a kidney. But the danger of infection when handling the peritoneum involved a risk of mortality from sepsis that limited the realization of the surgery.</p><p id="par0205" class="elsevierStylePara elsevierViewall">At present the exact time when the first nephrectomy was conducted is unknown, although this is not documented before the 15th century. The first lumbar subcostal nephrectomy was conducted by Gustav Simons (1824–1876) in 1869. He was a professor of surgery at Heidelberg and performed this type of nephrectomy on a patient with a double urethrovaginal and urethrocutaneous fistula secondary to gynecological surgery.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Following the disclosure of Simons's technique, numerous surgeons across Europe started performing nephrectomies despite the diagnostic limitations of the time. In Spain was Dr. Federico Rubio y Gali (1827–1902) at the Instituto Operatoria de Madrid, the first to perform a lumbar nephrectomy in 1874.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0215" class="elsevierStylePara elsevierViewall">Without intending to dethrone Saint Liborius as patron of urologists, a position previously claimed by peers from different European countries, the martyrdom of Saint Zoilus is, in the light of tradition and iconography provided, undoubtedly an urological issue.</p><p id="par0220" class="elsevierStylePara elsevierViewall">The history and tradition continues to this day. It is a Spanish saint with advocation in different parts of the peninsula, accessible to the urologist interested in our historical and artistic heritage.</p><p id="par0225" class="elsevierStylePara elsevierViewall">The tradition from a new point of view, urological, 1712 years later is claimed.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0230" class="elsevierStylePara elsevierViewall">The author declares that he has no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres655769" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec665379" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres655770" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultado" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec665380" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:2 [ "identificador" => "xack222018" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-10-24" "fechaAceptado" => "2015-11-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec665379" "palabras" => array:3 [ 0 => "History of urology" 1 => "St. Zoilus" 2 => "Urological martyrdom" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec665380" "palabras" => array:3 [ 0 => "Historia de la urología" 1 => "San Zoilo" 2 => "Martirio urológico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To highlight, for its urological importance, the martyrdom of St. Zoilus. To elaborate on the tradition of invocation and worship of the saint and to establish their historical bases.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a study of the images of the martyrdom of St. Zoilus, with a detailed review of the history and tradition of the saint and performed a comparative study of the various saints known as patrons of kidney pain and disease.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Result</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We found three paintings in different churches and locations depicting the kidney extraction of St. Zoilus. In addition to these three pieces, a preserved chest at the National Archaeological Museum and 2 tapestries in the sacristy of the church of the monastery of St. Zoilus in the Palencian town of Carrion de los Condes provided abundant information on the circumstances in which they were made. By analysing the style, we can deduce its affiliation to a specific artistic milieu and thereby propose a timeframe.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Without meaning to dethrone St. Liborius as the patron saint of urologists, an office claimed earlier by colleagues from various European countries, the martyrdom of St. Zoilus is, in light of the tradition and images provided, an unquestionable urological issue. The tradition is vindicated from a new viewpoint 1712 years later.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Poner de manifiesto, por su interés urológico, el martirio de San Zoilo. Desarrollar la tradición sobre la advocación y culto al Santo y sentar la base histórica de la misma.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de la iconografía encontrada sobre el martirio de San Zoilo, repaso pormenorizado de la historia y tradición del mismo y estudio comparativo de los distintos santos reconocidos como abogados del dolor o males de los riñones.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultado</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Encontramos 3 cuadros en distintas iglesias y localidades en los que se representa la extracción de los riñones a San Zoilo. Además el hallazgo de 3 piezas, una arqueta conservada en el Museo Arqueológico Nacional y 2 telares conservados en la sacristía de la Iglesia del Monasterio de San Zoilo, en la localidad palentina de Carrión de los Condes, proporcionan abundante información sobre las circunstancias en que fueron realizadas. De su análisis estilístico podemos deducir su filiación a un ambiente artístico concreto y proponer, en consecuencia, un marco cronológico.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Sin intención de destronar a San Liborio como patrón de los urólogos, cargo reivindicado con anterioridad por compañeros desde distintos países europeos, el martirio de San Zoilo es a la luz de la tradición e iconografía aportada indudablemente una cuestión urológica. Reivindicada queda la tradición desde un nuevo punto de vista 1.712 años después.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultado" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Domínguez-Freire F. El martirio de San Zoilo, una cuestión urológica. Historia y desarrollo de su tradición. Actas Urol Esp. 2016;40:317–321.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 741 "Ancho" => 992 "Tamanyo" => 131889 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Picture detail of the Iglesia de la Magdalena in the monastery of San Zoilo de Carrión de los Condes (Palencia).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1485 "Ancho" => 990 "Tamanyo" => 408517 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Image of the martyrdom of Saint Zoilus. Old Chapel of Nuestra Señora de la Concepción, from the Cathedral of Cordoba.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 986 "Ancho" => 1600 "Tamanyo" => 426822 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Image of the martyrdom of Saint Zoilus. Church of San Nicolás de Plasencia.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Florez E. España sagrada. vol. 10, Apéndice IV, capítulo XII. 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López Cubillana" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2008" "volumen" => "32" "paginaInicial" => "172" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18409465" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack222018" "titulo" => "Acknowledgements" "texto" => "<p id="par0235" class="elsevierStylePara elsevierViewall">To José Manuel and Teresa Domínguez Rey, proud natives from Carrión, that after 50 years in Galicia have not forgotten history, tradition, and way of speaking of their Castilian origin.</p> <p id="par0240" class="elsevierStylePara elsevierViewall">Their interest and knowledge have been genesis of this article.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000004000000005/v1_201605260128/S2173578616300166/v1_201605260128/en/main.assets" "Apartado" => array:4 [ "identificador" => "6274" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004000000005/v1_201605260128/S2173578616300166/v1_201605260128/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300166?idApp=UINPBA00004N" ]
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