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.
Pulmonary arterial hypertension (PAH) is a disorder of the arteries that connect the lungs to the heart. Symptoms are shortness of breath or laboured breathing (dyspnoea).
Pulmonary arterial hypertension is a rare and serious condition that affects the pulmonary artery system. As the disease progresses, blood flow reduces. To compensate for this, the right side of the heart grows excessively, creating breathing difficulties.
It is defined by a rise in pulmonary artery pressure caused by abnormalities in the precapillary pulmonary arterioles due to uncontrolled hypertrophy, hyperplasia and proliferation.
Dyspnoea, syncope, palpitations.
It affects children and adults, especially women (65-80%) and usually appears in adulthood.
In around 50% of cases of pulmonary arterial hypertension the cause is unknown. The other 50% are related to:
In Spain there are 16 cases for every million adults and the incidence rate is 3.7 for every million adults per year.
Diagnosis is via a series of tests:
Although they will not cure it, there are several treatments that can significantly improve the condition, its prognosis and patients’ quality of life.
We are fortunate to have access to all the pharmaceuticals beneficial in fighting this disease:
The decision about the most suitable drugs for each patient needs to be made by centres with experience. Lastly, if these measures are insufficient, a lung transplant can be considered in some cases.
Taking anorectics, amphetamines and cocaine should be avoided. The HIV virus can also cause this condition and all factors, principally alcohol, that may lead to liver failure. Apart from these measures there are no other means of prevention and efforts should focus on early detection.
Anticoagulant therapy involves the use of medications that reduce the blood’s ability to clot in order to prevent the formation of thrombi. It is used in thromboembolic diseases and in patients at risk of embolism to protect circulation.
There are different types of anticoagulants: injectable or oral.
Low molecular weight or unfractionated heparin. Should be started at therapeutic doses as soon as thrombosis is suspected, even before the diagnosis is confirmed, or as prophylaxis (prevention), at prophylactic doses, when the person has one or more risk factors that could trigger a venous thromboembolism (such as hip or knee replacement surgery). They are administered at fixed doses according to the patient’s weight, the type of thrombosis being treated or risk factor being controlled.
They are used as maintenance therapy when oral anticoagulants are contraindicated (e.g. pregnancy) or have been ineffective.
They are used as maintenance treatment (longer use) and are given on confirmation of the diagnosis of deep vein thrombosis or pulmonary embolism. There are two types of oral anticoagulants: vitamin K antagonists and direct-acting.
The anticoagulant treatment is controlled with blood tests or capillary blood tests (by pricking the patient's finger). Monitoring of patients on anticoagulant treatment is done by haematology and haemotherapy specialists.
At the Internal Medicine Department, we offer comprehensive internal medicine care to adult patients in our region, both at the Hospital and in Primary Care. We are a leading point of reference in both Catalonia and Spain in systemic autoimmune diseases. In addition, the Ageing and Chronic Patient Section covers Geriatrics and coordinates and collaborates with social-healthcare provision throughout the region.
The Internal Medicine Department is the cornerstone of medical care at Vall d'Hebron University Hospital. It is key in providing support to the other medical and surgical departments and the Accident and Emergency Department.
The Rheumatology Department's Teaching Unit is officially authorised for the training of resident Rheumatology interns. At present, we offer two training places for residents every year. One of our priority objectives is to attract and train resident doctors in order to return the knowledge we have gained to society and to further the training of highly-qualified professionals to face the future challenges of medicine, also known as personalised or precision medicine.
At the Rheumatology Section, we carry out extensive teaching activity, both in continuous education within the department itself, and in the organisation of seminars and courses aimed at professionals from other hospitals and other medical specialities. One of our objectives is to enhance the health workshops aimed at patients. We actively participate in national and international congresses.
We are a leading national and international centre with a high number of applications for training places, especially in the areas of paediatric rheumatology, chronic inflammatory arthritis and systemic autoimmune diseases, musculoskeletal ultrasound and central sensitivity syndromes.
We give theory and practical classes in Rheumatology in the Medicine Degree course at the Autonomous University of Barcelona. We also undertake intense teaching activities in Master’s courses and other postgraduate activities.
Rheumatology training itinerary
We are a clinical unit that aims to offer high-quality, cross-cutting care and teaching, as well as developing research excellence in the area of musculoskeletal and connective tissue diseases. We have extensive experience in training specialists in rheumatology. We guarantee rigorous, high-quality training in all the professional care, research and teaching skills in our area.
The training programme includes residents in the Rheumatology research group’s lines of research, so that they receive general training in research methodology, conventional and new areas of research, such as precision medicine, as well as evidence-based precision medicine, evidence-based medicine and research based on healthcare outcomes. Furthermore, our residents have the chance to undertake training periods in internationally renowned centres in both Europe and the United States.
Experience in research allows us to offer students a high-quality doctoral programme to carry out a thesis project and become a Doctor of Medicine. We also offer the opportunity to actively collaborate on research projects assessed by national and European public research bodies, and to co-author the resulting papers.
Why do your residency at Vall d’Hebron University Hospital?
Geriatrics is a speciality that consists of the comprehensive management of elderly people, requiring multidisciplinary participation in order to properly care for the patient. The Vall d'Hebron University Hospital Geriatrics Teaching Unit forms part of the Internal Medicine Department, and works in collaboration with the Faculty of Medicine at the UAB. It involves the participation of other hospital departments, including the Internal Medicine, Cardiology, Neurology and A&E departments.
Geriatrics training itinerary
Geriatrics residents must:
Residents are thus trained to offer a high quality service whereby a strong focus on the patient, with the help of the interdisciplinary team (medicine, nursing, social work, physiotherapy, psychology, etc.) and coordination with other primary care specialists, the intermediate care hospital and acute care hospital are vital.
This 4-year specialisation programme is split into two training periods:
Both the basic and specialised formative periods offer ample opportunities for elective rotations, including an external rotation during the final year.
The Geriatrics Teaching Unit encourages research, and offers the opportunity to do a doctoral thesis at the Autonomous University of Barcelona (UAB). Attendance at national and international geriatrics congresses, as well as that of the Catalan Geriatrics and Gerontology Society (SCGiG), is always encouraged.
The Hospital Radiophysics Teaching Unit is made up of hospital radiophysics specialists and senior technicians specialising in radiotherapy and/or radiodiagnosis.
Itinerario formativo en Radiofísica hospitalaria
The Medical Physics and Radiation Protection Department was accredited as a teaching unit in 1995 and is one of the first to receive accreditation in Spain. Some of our former residents now hold important positions in hospitals throughout Spain. Being part of Catalonia’s biggest hospital, with a technology park that is updated constantly, allows us to offer state-of-the-art training in all the areas of the speciality: radiotherapy, nuclear medicine, radiodiagnosis, and radiation protection in healthcare. It is unique, thanks to its extensive experience in advanced radiation oncology techniques in adult and paediatric patients, along with the scope of the radiation protection operations it carries out within the hospital, in both clinical and research facilities. The department has a laboratory where the hospital’s radiation detectors can be calibrated.
Additionally, the Vall d'Hebron Campus offers the possibility of actively participating in national and international research projects and clinical trials linked to its two research institutions, the Vall d'Hebron Institute of Oncology and the Vall d'Hebron Research Institute.
Why specialise at Vall d’Hebron?
The Internal Medicine Teaching Unit is led by the Internal Medicine Department and its various care units (General Internal Medicine, Hepatology, Autoimmune System Diseases, Infectious Diseases), with participation from the Cardiology, Respiratory Medicine, Neurology, Haematology, Oncology, Intensive Care Medicine and A&E Departments.
Internal Medicine training itinerary
Internal medicine is a core medical speciality that is practised primarily in hospital settings, providing comprehensive care to sick adults. It uses a medical approach in the prevention, diagnosis, therapeutic indication and follow-up of diseases in adults, including during their rehabilitation and palliative care. Internists are the backbone of the hospital, offering their versatility in acute and emergency hospitalisation; carrying out consultancy roles in primary care; and offering innovation in areas other than conventional hospitalisation and in the socio-health field.
The teaching unit is made up of 3 different departments. These include the Internal Medicine Department, which is broken down into the Systemic Autoimmune Disease Department, the Internal Medicine - Hepatology Department and the Infectious Disease Department. The Internal Medicine department is made up of different units which independently treat patients suffering from complex pathologies (Pleural Unit, Thromboembolic Diseases Unit, Autoinflammatory Diseases Unit and the Autoimmune Diseases unit).
In daily practice, resident medical staff visit patients together alongside specialist physicians. During these visits, medical records are drawn up and physical examinations are carried out. Visits can also entail clinical ultrasounds, diagnostic-therapeutic examinations (thoracentesis, paracentesis, arthrocentesis, liver biopsy, etc.) as well as differential diagnoses and the provision of diagnostic guidance. The pertinent examinations are requested and the treatment is duly adjusted.
During the IMR training, internal medicine residents learn how to diagnose and manage the most commonly found diseases on hospital wards and in internal medicine consultations. They will also learn about the most commonly treated pathology in other medical fields, obtaining a comprehensive and multi-disciplinary training that will allow them, upon the completion of their residency programme, to tackle a wide range of clinical scenarios with complete independence.
Moreover, in terms of specific areas of interest, residents will learn how to manage immunosuppressive therapies and patients suffering from cirrhosis, HIV and nosocomial infections, amongst other pathologies.
On-duty shifts are carried out in the A&E department in combination with inpatient care, preparing the Internal Medicine resident to treat critically ill patients in a fully independent manner upon the completion of their IMR training. It should be noted that residents treat patients suffering from a broad range of medical pathologies, meaning experience is gained in the management of patients suffering from conditions such as shock, respiratory failure (intubation and mechanical ventilation) and cardiac arrest.
Healthcare, teaching (sessions) and research tasks are carried out on a daily basis in all Internal Medicine departments. The Internal Medicine IMR will be progressively incorporated into these sessions, and will also participate in the research groups of his/her interest.
It is a chronic inflammatory disease of the oesophagus caused and prolonged due to an allergic reaction.It is typified by difficulty swallowing (dysphagia) any food blockages in the oesophagus (food impaction) and rupturing of the oesophageal wall (oesophageal perforation).
The most common symptoms are:
If the inflammation of the oesophagus and related symptoms are left untreated, they will continue from childhood to adulthood. This inflammation causes structural changes to the oesophagus by remodelling the tissue. This can lead to fibrosis and oesophageal stricture. This means functional deterioration that significantly affects the patient’s quality of life.
From the first recorded case in 1993, eosinophilic oesophagitis has been found to affect 45 out of every 100,000 people, and has an incidence rate of 3.7 cases for every 100,000 people a year. This makes it the most common cause of dysphagia, spontaneous oesophageal perforation and food impaction in young patients.
For appropriate diagnosis, a gastroscopy must be carried out to take multiple biopsies from the oesophagus, since inflammatory alterations can be distributed unevenly. This technique also allows the response to treatment to be assessed.
Endoscopic analysis of the oesophageal mucous membranes is not sufficient to reach a firm diagnosis, as 10-15% of patients will have normal results of a endoscopy.
Treatment for EoE is based on three alternative therapies:
Early diagnosis is important to prevent complications arising from EoE. Early treatment and clinical and endoscopic monitoring is also essential.
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