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.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
1. How the consumption of these substances affects the general population
The use of alcohol and other drugs usually increases among the general population during crisis situations, such as the one we are currently experiencing because of COVID-19. Beginning or increasing the consumption of alcohol and other drugs during this critical stage may trigger problematic substance use or addiction in the medium and long term.
The media recently reported that alcohol purchases, especially beer, have grown significantly. This increase in consumption may be due to the fact that many people use alcohol for the purposes of relaxing and entertainment while at home. At the same time, in times of crisis, alcohol consumption also increases among people who are less likely to purchase the drugs they use regularly, so they use alcohol to replace or alleviate the difficulties that this it entails for them.
Myths and truths related to the use of alcohol and other drugs
The following is a list of myths and truths about the use of alcohol and other drugs in order for us to reflect on, prevent, and become aware of what may cause and motivate this consumption.
Myth: Alcohol and other drugs relax us and relieve stress
Reality: Initially consumption can create pleasurable states, but then it can:
Myth: Alcohol gives us energy, makes us more active and enlivens us
Reality: Alcohol is a depressant to the nervous system and is not the answer to the boredom, apathy and discouragement caused by confinement, because after a brief sense of pleasure it will cause us to have less control over our emotions, fatigue and feelings of sadness.
Myth: It allows me to better control the situation
Reality: On the contrary, the use of alcohol or other drugs limits our self-control, making it difficult to follow strict confinement measures and increasing the likelihood of contagion.
Myth: It eases the pain
Reality: Alcohol or marijuana are not resources to use to ease the pain of existing chronic illnesses, because their use can have serious consequences for our general health, in addition the effect is very short term. They can lead to tolerance and addiction, and chronic consumption can increase pain sensitivity. Avoid using un-prescribed medication or increasing the dose of what you are taking without consulting a professional.
Myth: Beer is not alcohol
Reality: A glass of beer contains the same amount of alcohol as a glass of wine.
Myth: Beer quenches thirst better than water
Reality: Beer has a high percentage of water, but the alcohol it contains interferes with the reduction of a hormone (vasopressin), which increases the secretion of urine. Therefore, more fluid is expelled than ingested.
Myth: Alcohol is a food
Reality: Alcohol increases fat production and does not feed us. During confinement it is advisable to follow good eating habits, especially fruit and vegetable consumption.
Myth: It facilitates sex
Reality: Alcohol and other drugs may initially cause us to be uninhibited. But they later interfere with sexual ability and impede full sexual intercourse. Alcohol and drug use during confinement may lead to cybersex or impulsive sexting and cause greater exposure to such things than not using alcohol or drugs.
Myth: If I don't drink every day, I don’t have a problem
Reality: The damage caused by consumption is related to both quantity and intensity. It is more harmful to drink large quantities in a short period of time.
Myth: Alcohol and other drugs help us sleep
Reality: It is possible that the anxiety, fear and change of routine caused by the extraordinary situation at the moment are causing disturbances at bedtime. Turning to any substance will alter sleep quality.
Myth: Consumption kills the virus
Reality: No scientific study has confirmed this rumour. Excessive consumption of alcohol lowers our body's defences.
Myth: Alcohol is good for our health
Reality: Consumption causes physical problems that can be a risk if you suffer from COVID-19.
Myth: During confinement there is no social pressure
Reality: Many messages are circulating on social media inviting us to drink or use drugs.
Myth: During the crisis I have to increase my psychiatric medication
Reality: It is important to follow the guidelines agreed with your doctor. If necessary, contact your doctor by telephone.
Myth: Tobacco is not a drug and it eases anxiety
Reality: Tobacco is a stimulant drug and does not soothe anxiety but instead leads to withdrawal symptoms caused by its consumption.
How to know if I’m drinking more than I should
The World Health Organisation (WHO) has calculated a standard drink unit. Exceeding these guidelines may have negative consequences on physical, psychological, social or economic aspects of life.
What are the limits?
Men
Women
1 SDU (standard drink unit) = 10 g of pure alcohol
1 SDU
2 SDUs
The consumption of alcohol is contraindicated for:
Not only is the amount of consumption indicative of a problem, but so is when it is consumed to obtain an effect, alleviate or change your psychic state (to cheer you up or relax you) or if you need to drink in order to relate to others or to deal with adverse situations or personal difficulties.
When to seek the help of a professional?
It is advisable to be mindful of any changes in alcohol or other drug use. In the event that consumption causes problems, an increase in consumption is detected, or any mental, physical or social alterations are caused by it, it is important to try to gradually reduce the amount and frequency of alcohol or other drug use. If this is not possible, care should be taken not to increase your consumption and you should seek help from the referral centre.
2. Recommendations for patients with substance use disorders
COVID-19 can have a different impact on people who have or have had problems with alcohol or other drugs.
People with substance use problems may be more at risk of emotional distress during quarantine. On the other hand, people with the highest emotional distress are at higher risk of developing an addiction during this stage of the health crisis.
It is important for people who have quit drinking alcohol and other substances to stay motivated and seek new strategies to prevent relapses as well as maintain healthy routines, as confinement measures can lead to stress and emotional difficulties.
Similarly, many people may have been affected by the measures established in the Care and Follow-Up Centres (CAS), where face-to-face visits and group therapies have been cancelled.
In the face of this pandemic situation, measures such as spacing out or reducing urine tests, prolonging home treatment durations and frequency of methadone dispensing can significantly affect these people.
But this does not have to imply that the treatment has been abandoned or cancelled; visits can be made by telephone and professionals contacted by calling the referral CAS.
People with substance use disorders are at increased risk for SARS-CoV-2 coronavirus.
COVID-19 particularly affects the lungs, thus increasing the risk of health problems among people who smoke tobacco, cannabis or other drugs. Opioid users are more at risk of suffering COVID-19 complications due to the effect of the drug on the respiratory and pulmonary systems, and there is an increased risk of overdose. Cocaine use also causes blood vessels to constrict, which can lead to lung and respiratory problems.
Quarantine may make it harder for some users to get substances, which can lead to:
Measures to prevent the transmission of COVID-19 in people who consume substances:
In order to prevent contagion, the venipuncture centres and the syringe exchange units are being kept open and operational (with modification of the times and closing of some). You can contact the care and follow-up centres, the mental health referral centres and all the open Psychiatric Emergency Units by telephone if you have an extreme need.
If any person suspects that they have become infected with COVID-19, they must inform their healthcare professional about their situation regarding the use of substances, so that any possible complications and disorders can be taken into account.
Monkeypox is a zoonosis, an infectious disease that has spread from animals to humans. It is transmitted by direct or indirect contact with live or dead rodents or primates. Initial symptoms are usually a period of fever, headache and myalgia, a skin rash may appear between 1 and 5 days later. On 23 July 2022, the World Health Organisation declared the outbreak of monkeypox a public health emergency.
Monkeypox virus that usually occurs in the jungle regions of Central and West Africa. All cases identified outside these areas until May 2022 were imported or linked to animals. The main form of transmission is through direct or indirect contact with live or dead rodents or primates. Secondary transmission between humans is limited.
On 17 May 2022 an alert was received regarding the recent occurrence of several cases of Monkeypox with no history of recent travel to endemic areas or contact with other known cases. This is the first time that transmission chains have been reported in Europe with no known epidemiological links to West or Central Africa.
The initial symptomatology usually includes a period with fever, headache, myalgia, weakness and lymphadenopathy. A skin rash may appear between 1 and 5 days after the first symptoms, usually starting on the face and spreading to the rest of the body, including the palms of the hands and soles of the feet. The number of lesions can vary from a few to multiple disseminated lesions. In the current outbreak and given the transmission pattern, lesions are frequently located in the genital, perianal and perioral area, with an area of hyperpigmentation around the lesions. Characteristically, the lesions evolve in a uniform and sequential manner until they become crusts that dry up and fall off.
It usually evolves as a mild illness lasting 2 to 4 weeks, but complications such as pneumonia, pharyngeal lesions that compromise the airway, sepsis, encephalitis and corneal ulcers can appear, resulting in loss of vision.
Cases have been identified mainly in the population of men who have sex with other men, and in most cases the transmission mechanism identified is very close physical contact, mainly during sexual intercourse. However, the infection can affect anyone who comes into contact with an infected person.
The main transmission mechanism is currently through close and direct physical contact with lesions on the skin or body fluids of an infected person, during sexual intercourse or other continuous and prolonged contact over time.
It can also occur through other less important mechanisms such as face-to-face contact, respiratory secretions, or indirectly by coming into contact with objects used by an infected case. Furthermore, transmission can occur from pregnant women through the placenta to the foetus, as well as through contact with infected animals.
The incubation period is 6 to 16 days, but can range from 5 to 21 days.
The diagnosis is carried out by means of a specific test to detect the virus, with a PCR test.
The treatment is mostly symptomatic. Good hygiene must be maintained in the affected areas, which must be cleaned frequently or even with topical antiseptics. In lesions with superinfection, the application of topical or systemic antibiotics can be considered, following current guidelines. In the event of severe inflammation, the administration of corticosteroids may also be considered.
Specific antiviral treatments are reserved for severe complications and must be administered under hospitalisation. The only antiviral currently authorised for treatment is Tecovirimat.
The vaccine available against monkeypox is marketed under the name Jynneos and contains a virus that has been modified so that it cannot grow in humans, produce the disease or spread. As with other vaccines, when it is administered the immune system produces antibodies, which help to protect against the monkeypox virus.
Who is the vaccine recommended for?
Currently, the Spanish Government recommends the administration to people who:
Does the vaccine work?
The vaccination schedule consists of two doses of vaccine separated by a minimum of 28 days and most people develop antibodies. For this reason, it is expected to provide a good level of protection against monkeypox
At the moment the availability of doses is severely limited, so that only one dose of the vaccine is offered to the maximum number of people. This can help to modify or reduce monkeypox symptoms. The response with a single dose of the vaccine is lower than with two doses and is not immediate: becoming effective approximately 4 weeks after receiving the vaccine.
Vaccine side effects:
Like all medication, this vaccine can cause side effects, although not everyone suffers from them. The most common include pain and itching at the injection site and headache, muscle pain, malaise and fatigue. Approximately 1 in 10 people will have chills and a fever, but they should not last more than a few days. If you experience any of the side effects mentioned above, you should rest and take the appropriate dose of paracetamol to help alleviate the symptoms.
Preventive Medicine and Epidemiology, Cross-departmental services
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