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.
We will guide you from your first visit to the centre, allowing you to find all the departments and make the most of our facilities. Whatever the reason for your visit, we will explain how to get about the hospital.
Children's Hospital and Woman's Hospital
The Escherichia coli (E. coli) bacteria is one of the most common causes of human illness. It forms part of the digestive flora and is always present in faecal matter.
By little known mechanisms it episodically causes disease in humans, either due to mutations that make it resistant to our body’s control mechanisms, or because it is present in places it should not normally be, such as the urinary tract or in the blood itself.
E. coli infections cover a range of severities, from a urinary tract infection which causes urinary discomfort, to infections from very aggressive strains such as the O157 strain: H7 causes Haemolytic Uraemic Syndrome (HUS).
A urinary infection caused by E. coli is the most common infection caused by the bacteria.
The low-severityE. coli infection that leads to a urinary tract infection is much more common than that which leads to HUS, which is considered a rare condition, and very uncommon in the general population.
In the case of HUS, a rare condition as previously stated, the E. coli bacteria causes bloody diarrhoea and blood clotting in the smallest veins (thrombotic microangiopathy). This leads to kidney failure and also the alteration of other organs such as the heart and brain.
HUS is a serious phenomenon, which, if is not diagnosed and treated early, can cause death.
Infection with E. coli, which primarily affects the urinary tracts, causes discomfort when urinating, pain and increased frequency of urination, and fever if the kidneys are affected.
HUS is characterised by a feeling of general unwellness, bloody diarrhea, with or without a fever.
Infection by E. coli, normally a urinary infection, affects breastfeeding infants who do not have control of their sphincters, something which facilitates the extension of the intestinal flora into the urinary tract, and also in women of childbearing age.
HUS can occur at any age, but is most common between the ages of 4 and 12, after having consumed foods contaminated with E. coli O157, normally meat or dairy products from cows that are themselves infected with E. coli O157.
E. coli is diagnosed in the Microbiology laboratory, using cultures of a suitable medium, or through detection using techniques of molecular biology.
The treatment is an antibiotic, either oral or intravenous, depending on the extent of the infection and the patient’s general condition.
The treatment for HUS caused by E. coli is always hospitalisation, with the possibility of hemodialysis being prescribed to treat renal failure.
Patients with HUS produced by E. coli very often make a full recovery, despite it being a serious disease.
In the case of suspected E. coli, it is necessary to identify E. coli, generally in the blood or urine, through cultures, to confirm the diagnosis and prescribe the appropriate antibiotic.
Additionally, if infection by E. coli is confirmed, an image test such as an ultrasound is indicated in order to evaluate the state of the kidneys and urinary tracts.
If HUS is suspected, hospitalisation is always indicated to check for signs of thrombotic microangiopathy (TMA): anemia, renal failure, decreased platelet count, and broken or fragmented red blood cells.
A universally effective prevention for E. coli does not exist.
It is important to drink a lot of water in order to urinate every 2-3 hours, and above all not to hold pee in when you feel the urge to go.
Veterinary control of animals who carry E. coli O157 is fundamental for the prevention of HUS.
Paediatric age onset systemic autoimmune diseases are infrequent, complex entities that require a multi-disciplinary approach. The most frequent include juvenile onset systemic lupus erythematosus, mixed connective tissue disease, juvenile onset Sjögren’s syndrome, juvenile dermatomyositis, juvenile scleroderma, and paediatric age onset vasculitis, such as Kawasaki disease, IgA vasculitis (also known as Schönlein-Henoch purpura), polyarthritis nodosa and Takayasu disease.
The clinical manifestations of these diseases are highly varied. Juvenile systemic lupus erythematosus may affect several organs in the body, particularly the skin, joints, blood, kidneys and the central nervous system. In children, it is common for fever to appear without an infectious cause or an increase in the size of the lymph nodes.
Juvenile dermatitis is characterised by the presence of fatigue, muscle pain, weakness and the appearance of rashes that may affect the face, with inflammation around the eyes (periorbital oedema) There may also be reddening of the cheeks (malar rash) and other parts of the body (top part of the knuckles, knees and elbows), where the skin may become thicker (Gottron’s papules).
Juvenile scleroderma, whose name comes from the Greek and means “hard skin”, is characterised by the presence of lesions on the skin and affects various organs. Two types can mainly be identified: localised scleroderma and systemic scleroderma.
Kawasaki disease is characterised by the presence of a high fever of unknown origin, irritability, reddening of the eyes and various skin lesions, such as a rash on the torso, flaking fingers and reddening of the tongue (normally called “strawberry tongue”). The involvement of the heart is the most serious manifestation of Kawasaki disease, due to the possibility of long-term complications.
Schönlein-Henoch purpura is characterised by a rash on the legs called “palpable purple” because the skin lesions can be touched, and painful and swollen joints, abdominal pain and kidney problems may appear.
All the conditions within the group are infrequent and have an incidence of less than 5 cases per 10,000 inhabitants, for which reason they are considered to be rare conditions. The spread is different depending on the disease. For example juvenile systemic lupus erythematosus, along with juvenile dermatomyositis and scleroderma, are more common in girls, while Schönlein-Henoch purpura is more common in boys.
Diagnosis of paediatric systemic autoimmune diseases is eminently clinical and we are guided by classification and diagnostics criteria in many of them. Blood tests are important for diagnosing the different systemic autoimmune diseases, as various autoantibodies can be identified that can help with the diagnosis and monitoring of these diseases. Supplementary tests, such as a capillaroscopy, chest X-ray, respiratory function tests, nuclear magnetic resonance and echocardiogram, amongst others, can be helpful when we come to approaching a paediatric patient with a suspected systemic disease.
Treatment fundamentally depends on the type of condition and the response to the therapy chosen. There is not currently any specific curative treatment for each one of the diseases, but the treatments available will help to control the signs and symptoms of the disease and prevent complications, including permanent damage to organs and tissue.
Malaria is an infectious disease caused by the parasitic protozoan Plasmodium.
It is transmitted through the bite of mosquitoes of the genus Anopheles. The mosquito acts as a vector or transmitter of the disease. The mosquito bites an already infected person. The parasite reproduces and develops inside the mosquito. The mosquito subsequently bites another person who in turn becomes infected.
It cannot be transmitted from one person to another without the presence of a mosquito, except in the case of an infected blood transfusion or from mother to foetus through the placenta.
Mosquitoes generally bite during hours of low light: dusk, during the night and dawn. They live in urban as well as rural areas. During the rainy season there are more mosquitoes, therefore the risk of being bitten and contracting the disease is higher.
Malaria was eradicated in Europe over 50 years ago, and so cases seen are due to travel to endemic countries for reasons such as immigration, tourism, and business. The majority of cases are seen in immigrants after having returned to their native countries to visit family. This occurs due to the fact that although they should be taking the same measures as tourists, more often than not they do not. 95% of cases are imported from Africa, 3% from Asia and 1% from South America.
The incubation period varies from one week to over a month. As such, symptoms may present themselves shortly after entering an endemic area or several months after having returned from one.
Symptoms generally include high fever, chills, headache, sweating, and generalised joint and muscle pain. Some patients experience symptoms every 2-3 days and others experience a persistent fever. If the disease is not diagnosed and treated accordingly it can develop rapidly and become life-threatening. Alterations in consciousness, convulsions, coma, difficulty breathing and haemorrhaging are signs of a bad prognosis. Requires immediate medical attention.
It is important to keep in mind that any child with a fever and history of travel to an endemic country should be suspected of having malaria unless proved otherwise.
Malaria is common in tropical and subtropical areas (both sides of the equator). The countries in which malaria is endemic have been grouped into 4 regions: Africa, America, Asia and the Pacific, and the Middle East and Eurasia. More than 90% of the malaria cases in Africa are caused by Plasmodium falciparum, the most serious and deadly. America and the Middle East and Eurasia are dominated by Plasmodium vivax. A much more common form of malaria with a lower mortality rate.
In Asia and the Pacific, infections are a mix of Pl. vivax and Pl. falciparum with a moderate number of cases of mortality. Generally speaking, the areas with the highest risk for travellers are Sub-Saharan Africa, South East Asia, Papua New Guinea and the Indian subcontinent.
A diagnosis is reached through detection of the parasite either in the red blood cells, or through processes of molecular biology.
Early diagnosis is crucial. The pharmaceuticals used in Europe differ from those used in endemic countries in places like Africa. Depending on the severity, certain intravenous drugs may be required immediately. Severe malaria is usually treated in Intensive Care Units in anticipation of serious complications.
In a case of suspected malaria, blood testing is crucial. If there are alterations in any organs, individual exploration of said organs is necessary; for example, brain image scanning in the event of nervous system impairment, which is very common in severe cases of malaria.
With malaria, prevention is crucial. The use of antimalarial medication before travelling to endemic countries is vital, as failure to do so means the probability of contracting the disease is very high due to the fact that it is almost impossible to avoid mosquito bites even by using insect repellent and mosquito nets.
Antimalarial medication, to be prescribed by a doctor in each case, should be started before beginning a trip up until a few days after returning.
It is essential for patients to actively participate in the monitoring and treatment of their disease to increase their personal satisfaction and autonomy. Having reliable, verifiable information is also of great help in managing the disease.
Hereditary angioedema is such a rare disease that it is little-known even among healthcare workers. This means that in this case the patients themselves particularly need to know how to act in the event of an emergency, especially when they are not in their usual environment or are far away from their medical team.
It is advisable, as far as possible, to avoid possible triggers or aggravators of attacks:
The following symptoms indicate a suspected case:
The doctor must make a correct differential diagnosis in order to rule out other causes, such as appendicitis.
In this case it is important to remain calm and follow the doctor’s instructions. Here is some general advice:
1. Ask someone to help you explain what is happening to you.
2. Have the clinical report issued to you by your doctor at the ready.
3. If you have rescue or emergency medication (intravenous Berinert® or Cinryze®, or subcutaneous Firazyr®):
a) If you have been taught how, self-administer it in accordance with the instructions.
b) If you cannot administer it yourself, take it with you to the health centre.
4. Go to your nearest health centre for emergency treatment.
5. Make an appointment with your specialist once the immediate crisis has been dealt with.
In the case of a significant symptom burden in type I and II angioedemas, C1-INH may be administered as a prophylaxis.
TRANSFUSIONS – CAN I GIVE BLOOD?
It is not advisable for patients with hereditary angioedema of any type or acquired C1-inhibitor deficiency to donate blood.
LONG OR FOREIGN TRIPS
We recommend you take an up-to-date copy of the clinical report issued by your doctor with you. It is a good idea to have the report translated into the language of your destination or English.
Find out where the nearest healthcare centre is.
Always carry rescue or emergency medication with you and make sure it has not expired. Have your medical report to hand at security controls at airports or railway stations to avoid problems.
You do not have a follow a special diet because it is not an allergic oedema and it is not caused or triggered by a food allergy.
Diet does not have any impact on the evolution of the disease. You should, of course, follow the healthy diet recommendations issued to everyone.
Not all upset stomachs are the same. There are two types: organic, with a clear cause, and functional or recurrent. This advice is focused on the former. The causes of upset stomach vary greatly. The most frequent cause is associated with gastroenteritis, constipation or indigestion. Often children express their physical discomfort (fever, sore throat, etc.) or emotional discomfort (stress situations above all) in the form of stomach pain. Other factors that pull the wool in front of our eyes are appendicitis, urinary infections, intussusception and a long list of diseases that cannot be overlooked, which have a significant impact on children because they make them feel ill.
Upset stomach appears when viruses, parasites or bacteria damage the cells in the mucous membrane in the intestine. Normally, this membrane absorbs fluids, but when it is damaged it can no longer do it as effectively. The body therefore loses fluid through vomiting and diarrhoea.
Diarrhoea causes loss of fluids and salts. Children are more vulnerable to loss of fluids than adults; as they are smaller, they become dehydrated more quickly. Vomiting may lead to difficulties retaining the fluids consumed. Smaller children may deteriorate if they lose more fluids than they take in. This is why it is important that they drink from the onset of the stomach infection.
Vomiting and diarrhoea are the most common symptoms of upset stomach caused by a virus in children. The illness almost always cures itself and disappears in a couple of days. It is very important for children to drink fluids, especially if they have diarrhoea, which is particularly relevant in children under one year.
When children are suffering from upset stomach they may present different symptoms, including: vomiting, diarrhoea, discomfort, tummy ache, fever, tiredness and loss of appetite.
The symptoms normally appear all of a sudden, a couple of days after being infected, and disappear after a few days. Diarrhoea may last up to a week. Upset stomach is more common in winter, when children spend longer indoors. Although it may also be caused by bacteria, parasites or viruses, eating food that has gone off or travelling abroad.
You should go to your doctor or call 061 CatSalut Respon (Catalan Health Service care line) in the following cases:
You should seek urgent medical assistance if the child has diarrhoea, vomiting and any of these symptoms:
Children need fluids. They need to drink often. They can drink a bit at a time, in small quantities given to them with a spoon or bottle. Offer them water occasionally. It is important that they drink a bit at time, as if they drink too much in one go they may start vomiting again.
Avoid sweet drinks such as fizzy drinks or strong juices. They should also avoid diet drinks, as although they do not contain sugar, they may contain other products that cause diarrhoea. Infants may drink what they like, the most important thing is that they drink fluids.
If the child does not want to drink, try giving them ice lollies. You still need to offer them fluids. Even if they are eating ice lollies, they need to drink fluids to rehydrate themselves.
If the child is breast or bottle feeding, they should keep doing so, only more often, even if they vomit. If they do not want to breastfeed, you can also extract milk and feed them from a spoon.
A special syringe for medication is a good solution for oral rehydration. Make sure the liquid does not land directly on their palate, as this may cause nausea.
If vomiting is continuous, the child needs to drink two spoonfuls of liquid every five minutes, which is the equivalent of about 10 ml. An infant needs approximately 1 litre of liquid every 24 hours.
Oral solutions contain the amounts of salts and sugars required to help restore the body’s water balance. When children vomit often and have serious diarrhoea, it is a good idea for them to drink oral rehydration solutions. The infant may not want to drink the solution. If that is the case, try adding sugar.
You can find these solutions in pharmacies.
In most cases, it may be that the child stops vomiting but the diarrhoea continues for a while. Breastfeeding babies can continue feeding and babies drinking from a bottle can eat different types of preparations: rice, corn, formula milk, etc. depending on their age. You can find these preparations in pharmacies. You should start with small quantities.
If the child is older than six months, they may eat carrot soup.
When they are ready to start eating, it is better for them to eat normal foods. It is better to start with small quantities of food and avoid fruits and foods that have a fibre content.
If the child starts vomiting again and is more tired than usual, does not have enough energy to play or loses their interest in their surroundings, see a paediatrician.
Often, upset stomach is caused by a viral infection that is highly contagious. It is normal for people in the same family to be ill at the same time.
To prevent it from being passed on:
It is advisable for the child not to go back to nursery or school until two days after the symptoms disappear.
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