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.
The immune system is a defense and adaptation system of our body in relation to the external environment. It allows us to distinguish what we accept and what we do not from everything around us—foods, germs, chemical substances, our own aged or damaged cells, etc.—in order to preserve good health. All disorders caused by either an excess or a deficiency of this function are included within these diseases.
It has two fundamental components: innate immunity, which depends on the genes of our species and does not need to be trained to function, and acquired immunity, which depends on the learning process of our body through contact with infections, foods, or chemical substances. Both work together in close collaboration and in a delicate balance.
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.
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 acceptance of these terms implies that you give your consent to the processing of your personal data for the provision of the services you request through this portal and, if applicable, to carry out the necessary procedures with the administrations or public entities involved in the processing. You may exercise the mentioned rights by writing to web@vallhebron.cat, clearly indicating in the subject line “Exercise of LOPD rights”. Responsible entity: Vall d’Hebron University Hospital (Catalan Institute of Health). Purpose: Subscription to the Vall d’Hebron Barcelona Hospital Campus newsletter, where you will receive news, activities, and relevant information. Legal basis: Consent of the data subject. Data sharing: If applicable, with VHIR. No other data transfers are foreseen. No international transfer of personal data is foreseen. Rights: Access, rectification, deletion, and data portability, as well as restriction and objection to its processing. The user may revoke their consent at any time. Source: The data subject. Additional information: Additional information can be found at https://hospital.vallhebron.com/es/politica-de-proteccion-de-datos.