We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
Immunological diseases can impair the body’s defense system or cause an inappropriate immune response. Proper medical follow-up, adherence to treatment, and healthy lifestyle habits are essential to prevent infections, manage symptoms, and improve quality of life.
A person’s immune status depends on their overall health: proper nutrition and avoiding exposure to tobacco smoke and chemicals whenever possible. In early childhood, the vaccines and immunizations recommended in the vaccination schedule help build a competent immune system.
In primary immunodeficiencies, early detection is important, usually indicated by the presence of frequent infectious diseases. Secondary immunodeficiencies occur during treatment for neoplasms or in transplant patients who must take lifelong immunosuppressive medication.
In autoimmune diseases, it is essential to follow the prescribed medication, often for life, and to avoid excessive cold and sun exposure, which can trigger disease manifestations. To maintain the functionality of joints and muscles, following specific rehabilitation guidelines is important.
In immune deficiency, administering immunoglobulins (blood proteins responsible for our defense) can play an important role. When the deficiency affects immune cells, immunoglobulins are not effective; in such cases, antibiotics can prevent or reduce infections.
In diseases caused by excessive or poorly regulated immune responses, anti-inflammatory drugs and medications that modulate immunity are used, such as corticosteroids and biologics, which block specific inflammatory pathways. Other drugs may also have beneficial effects through less well-understood mechanisms, such as some medications used to treat malaria.
Immunological diseases are disorders in which the immune system does not function properly, either due to overactivity or deficiency. This imbalance can cause inappropriate responses to external agents or damage the body’s own tissues.
Immune System Diseases
There are immune system disorders caused by:
a) Loss of function: Primary immunodeficiencies, acquired immunodeficiencies.
b) Excess of function: Autoimmune diseases, in which the body, through an excessive exercise of its defenses, attacks itself due to the loss of a fundamental function: self-tolerance. This means that under normal conditions, a body’s own cell will never attack another of its own cells.
In the first case, immunodeficiencies are indicated by the repeated occurrence of infections, which is the key sign for detection. These can appear early in life due to a genetic alteration, in adulthood as a result of treatments for other diseases such as cancer, or can be acquired through viral infections, with HIV (human immunodeficiency virus) being one of the most significant.
In the second case, autoimmune diseases are suggested by the appearance of inflammation without apparent cause in joints, lungs, kidneys, liver, or other organs.
Symptoms primarily depend on whether they are due to a loss of function (recurrent infections) or an excess of function (inflammatory disease affecting one or more organs).
Immune diseases can affect anyone throughout their life. In general, immunodeficiencies are more common in early childhood, while autoimmune diseases usually affect young adults, more frequently women.
The body’s defense capacity is assessed in two ways:
Basal state: in the patient’s ordinary condition.
After stimulation: the immune cells are stimulated in the laboratory to evaluate their function.
For autoimmune diseases, factors present in the blood are analyzed; elevated levels may indicate abnormal activity against the body itself.
Diagnostic evaluations include:a) Study of innate immunityb) Study of acquired immunityc) Study of the functional capacity of the immune systemd) Study of factors characterizing autoimmune disease
Assessing immune competence can be done in several ways:
Detection and counting of immune cells, specifically lymphocytes.
Laboratory stimulation of lymphocytes to test their functionality.
Analysis of blood or biopsy samples for factors causing self-attack, such as autoantibodies (defense proteins with abnormal self-aggressive function).
Study of elevated cellular messengers indicating the activity of these cells against the body.
Immunodeficiency: restoration of the immune system’s functional capacity.
Autoimmunity: modulation or inhibition of the immune system’s self-aggressive capacity.
Laboratory tests to assess immune system functionality are standard. Genetic tests are also used to assist in diagnosis.
In addition to general recommendations for a healthy diet, regular exercise, and abstaining from smoking, adherence to the childhood vaccination schedule is essential. Vaccinations not only protect against specific infections but also help improve overall immune defense.
Spina bifida is a congenital neural tube defect that affects the spinal cord and vertebral column. It occurs when these structures do not close properly during fetal development and may cause motor, sensory, or functional impairments.
The term neural tube defects (NTDs) or spina bifida refers to a diverse group of congenital malformations of the central nervous system that primarily affect the spinal cord and vertebral column.
In the most severe cases, such as myelomeningocele and meningocele, there is a failure of the vertebral column to close, allowing the spinal cord to protrude externally (open defects). Milder forms, such as lipomas or lipomyelomeningocele, present as a soft mass covered by skin, a hairy lumbar patch, or may go unnoticed (closed defects). The most severe defects can be associated with other brain malformations, such as Chiari II malformation.
The cause of neural tube defects (NTDs) is unknown, but current evidence suggests that genetic predisposition combines with external factors. Some of these factors are recognized (such as valproic acid or methotrexate), but in most cases, they are related to a deficiency or interference in folic acid metabolism.
Administration of folic acid to women before conception has reduced the incidence of the malformation.
Prenatal diagnosis is usually performed via ultrasound. Since 2011, our hospital has applied an ultrasound-based technique, developed by rehabilitation doctors and obstetricians, that allows prenatal determination of the type and motor level of the fetus with spina bifida. This enables an individualized and reliable prognosis of the child’s motor and functional abilities.
Patients with myelomeningocele:
Patients with lipomas or lipomyelomeningocele:
The treatment of choice for open defects is prenatal surgical closure between 24–26 weeks of gestation, aiming to minimize sequelae from the malformation.
From birth, a child with spina bifida must be monitored in a specialized unit that guarantees their lifelong care and therapeutic needs. The multidisciplinary team should include obstetricians, pediatricians, neurosurgeons, urologists, orthopedic surgeons, pediatric surgeons, rehabilitation doctors, physiotherapists, occupational therapists, nurses, and orthotic technicians.
Treatment must be individualized, as different types of neural tube defects lead to different sequelae.
Basic objectives of NTD treatment:
The Spina Bifida Unit at our hospital has existed since the 1970s. It is the only unit in the area that can provide continuous care from birth throughout life, with the same team of professionals.
The rehabilitation doctor coordinates the unit, integrating the various therapeutic proposals to ensure they are realistic and achievable. This approach prevents unfeasible recommendations that could cause disappointment for families and suffering for the patient.
Treatment with the drug levodopa allows many of the functions deteriorated or lost due to the disease to be restored. It is the most effective treatment, but it also has limitations: as the disease progresses, its effect becomes transient and fluctuates. When the medication is working, the patient feels well, in the "On" state. When the effect wears off, the patient enters the "Off" state, and symptoms reappear.
To improve the effects of levodopa, different routes of administration have been investigated (inhaled, transdermal, intrajejunal) and various pharmaceutical formulations have been developed. Administration via gastrostomy with a levodopa gel infusion has been particularly successful.
There are also other pharmacological and neurosurgical treatments, such as electrical stimulation of specific brain areas, which provide good results. Research is ongoing to target the diseased brain using stereotactic ultrasound, avoiding trepanation and traditional surgery.
New avenues of research have opened in Parkinson’s disease to determine its causes, prevent its progression, and maximize symptom management.
Low-intensity physical exercise, practiced regularly and consistently—such as simply walking for half an hour to an hour each day—helps preserve automatic and semi-automatic motor functions.
Walking involves two aspects of movement: voluntary and automatic. The voluntary movement would be the act of taking steps, while others—such as arm swinging, foot placement when stepping, head and neck position, etc.—have an important involuntary component.
All body movements benefit from exercise. The motor abilities we all have, which seem easy and permanent, are not necessarily so. Certain movements—like touching the floor with your fingers while keeping your legs straight—can be lost over time if not practiced.
We need constant maintenance, perhaps of low intensity, but sustained over time, to enjoy the full potential of our bodies throughout life.
Intensive Care Medicine, General Hospital
Physical Medicine and Rehabilitation, Traumatology, Rehabilitation and Burns Hospital
The Physical Medicine and Rehabilitation Department offers comprehensive. multidisciplinary treatment for patients, with the aim of achieving the highest level of autonomy, functional capacity and quality of life, using therapeutic measures and technical support aimed at correcting or minimising the disability diagnosed.
Ours is a transversal department, meaning we collaborate with many other medical and surgical departments at the Hospital. Our ability to provide support in all healthcare areas guarantees coordinated care for patients throughout their stay. We are a reference centre in Catalonia for various highly complex processes (spinal cord injury, acquired brain damage, spina bifida, burns) and we also engage in teaching and research.
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