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Correct use of acronyms

Currently, the use of acronyms in medical texts is very frequent. However, despite the proliferation of their use (sometimes abuse), they are often used or written incorrectly. In this regard, we have observed that various authors repeatedly use erroneous forms of some acronyms (particularly NSAIDs and ACEIs) in articles published in this and other scientific journals.

In recent years, several works have been published in which the correct use of acronyms in Spanish is widely discussed (1-5); The reason for this letter is to comment on two aspects in which we have observed inaccuracies with some frequency: not writing the transcription of the full name when an acronym is used for the first time and incorrectly forming the plural of the acronyms.

An acronym, according to the Dictionary of the Spanish Language (6), is "a word formed by the set of initial letters of a complex expression". The word acronym designates both each of the initial letters of the words that are part of a denomination and the word formed by the set of these initial letters (7). The acronyms, in the latter case, are generally formed with the initials of names and adjectives of a title or denomination (as in the case of ACEI, "angiotensin converting enzyme inhibitor"), although they can also intervene in their formation letters that are not initials (as in the case of NSAIDs, "non-steroidal anti-inflammatory").

When an acronym is used in a text, the full name must be transcribed the first time it is mentioned, followed by the corresponding acronyms in parentheses. In subsequent allusions, only the acronym is sufficient and it is not necessary to develop it again (2,3). In the title and in the abstract it is better not to use acronyms but, if they are used, they must also be explained; this explanation does not exempt from the obligation to develop them the first time they appear in the text.
Before addressing the plural of acronyms, it is worth remembering other interesting aspects as well. The Royal Spanish Academy (7) clearly indicates that acronyms, in current use, are written without dots or whites (dots are only written after the letters that make up the acronyms when they are integrated into texts written entirely in capital letters), they present normally all the letters that compose them are capitalized, they never have an accent (although their pronunciation requires it according to the accentuation rules) and they must never be divided by a hyphen at the end of the line.

Some acronyms can be acronyms. An acronym is, on the one hand, the term formed by the union of elements of two or more words, normally constituted by the beginning of the first and the end of the second or, also, by other combinations (for example, Inserso, from National Institute of Social Services) and on the other hand, an acronym is also called the acronym that is pronounced as a word. Due to their pronounceable form, it is very common that acronyms, after a first phase in which they appear written in capital letters due to their condition as acronyms (ICU, AIDS), end up being incorporated into the common lexicon of the language and are therefore written with lowercase letters (uci, sida), except when it comes to names or denominations that require writing with a capital initial (Unesco, Unicef). The formation of initials and acronyms is a widespread phenomenon in Anglo-Saxon countries, especially in scientific-technical fields. Many words that are originally English initials or acronyms (laser, radar, telex) have been incorporated into our language. In some cases, foreign acronyms have been adapted or translated into Spanish, and thus, we do not say aids (acquired immunodeficiency syndrome), but AIDS (acquired immunodeficiency syndrome). When acronyms are incorporated into the lexical flow of the language as common names, then they must be subject to the rules of graphic accentuation in Spanish (laser) (7).

Acronyms, like acronyms, and unlike abbreviations (reduced graphic representation of a word or group of words, obtained by removing some of the final or central letters or syllables from their complete writing, and which always closes with a point) and the symbols (abbreviations of a scientific-technical nature, made up of letters or, on occasion, non-alphabetizable signs, which, in general, are set conventionally by standardization institutions and have international validity) are read without resetting the text they replace. Initials and acronyms, therefore, are not only graphic abbreviations, but also oral ones. One of the most frequently observed errors in the use of acronyms in medical texts arises when they are used in the plural. In Spanish, in writing, the plural of acronyms is invariable (7), that is, they do not change their form when they designate a multiple referent (the acronyms do not admit plural by inflection, that is, adding an -s to the singular form) . Therefore, the acronyms, as such, do not have a plural, although they may reflect a plural statement (1); in this case, the indication of plurality is made through the article that precedes them or the words that introduce them (the NSAIDs, various ACEIs,...). A separate case is made up of those acronyms, few, which, without admitting - like all of them - plural by inflection, can contain it in their own structure of meaning; in that case, they double each of the initial letters (this is the case, for example, of USA, acronym for the United States) (4.5). Thus, it is completely incorrect to speak of NSAIDs, NSAIDs, NSAIDs, ACE inhibitors or ACE inhibitors, since, as has been said, the plural should not be made by adding an s, preceded or not by an apostrophe, in a similar way to what is done, correctly, in English (for example, NSAIDs - acronym for non-steroidal anti-inflammatory drugs) (8). Keep in mind, however, that acronyms, once incorporated into the common lexicon, form the plural following the general rules of their formation in Spanish, that is, adding -s if they end in a vowel (ucis) or -es if end in a consonant (lasers, radars) (7). United States acronym) (4.5). Thus, it is completely incorrect to speak of NSAIDs, NSAIDs, NSAIDs, ACE inhibitors or ACE inhibitors, since, as has been said, the plural should not be made by adding an s, preceded or not by an apostrophe, in a similar way to what is done, correctly, in English (for example, NSAIDs - acronym for non-steroidal anti-inflammatory drugs) (8). Keep in mind, however, that acronyms, once incorporated into the common lexicon, form the plural following the general rules of their formation in Spanish, that is, adding -s if they end in a vowel (ucis) or -es if end in a consonant (lasers, radars) (7). United States acronym) (4.5). Thus, it is completely incorrect to speak of NSAIDs, NSAIDs, NSAIDs, ACE inhibitors or ACE inhibitors, since, as has been said, the plural should not be made by adding an s, preceded or not by an apostrophe, in a similar way to what is done, correctly, in English (for example, NSAIDs - acronym for non-steroidal anti-inflammatory drugs) (8). Keep in mind, however, that acronyms, once incorporated into the common lexicon, form the plural following the general rules of their formation in Spanish, that is, adding -s if they end in a vowel (ucis) or -es if end in a consonant (lasers, radars) (7). The plural should not be made by adding an s, preceded or not by an apostrophe, in a similar way to what is done, correctly, in English (for example, NSAIDs - acronym for non-steroidal anti-inflammatory drugs) (8). Keep in mind, however, that acronyms, once incorporated into the common lexicon, form the plural following the general rules of their formation in Spanish, that is, adding -s if they end in a vowel (ucis) or -es if end in a consonant (lasers, radars) (7). The plural should not be made by adding an s, preceded or not by an apostrophe, in a similar way to what is done, correctly, in English (for example, NSAIDs - acronym for non-steroidal anti-inflammatory drugs) (8). Keep in mind, however, that acronyms, once incorporated into the common lexicon, form the plural following the general rules of their formation in Spanish, that is, adding -s if they end in a vowel (ucis) or -es if end in a consonant (lasers, radars) (7).

NSAIDs and ACE inhibitors are just examples of pharmacological nomenclature affected by incorrect pluralization. We could add SSRIs (selective serotonin reuptake inhibitors), ARBs (angiotensin receptor antagonists), LAs (local anesthetics), MAOIs (monoamine oxidase inhibitors), PPIs (proton pump inhibitors) and PG (prostaglandins), as well as acronyms widely used in other areas: the EAP (primary care teams) and the ABS (basic health areas), so frequent in family and community medicine texts, serve as an example.