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.
Asthma is a disorder of the passage of air through the respiratory tract, particularly in small-calibre bronchial tubes. It causes difficulty breathing and the patient feels like they are drowning and must increase their effort in an attempt to breathe better.
Asthma is a chronic inflammatory disorder of the airways that results in variable airflow obstruction. It often changes throughout the day (it can get worse at night) and improves with treatment and then reappears later.
The illness is basically caused by an inflammatory mechanism.
Three phenomena occur in the airways of patients with asthma:
1. Decreased bronchial diameter, which restricts air flow.
2. Inflammation, with increased thickness of the bronchial wall, which also contributes to restricting air flow.
3. Increased activity in the glands that produce mucus, with increased secretions contributing further to breathing difficulty.
Cells that circulate in the blood are involved in the local inflammation observed in asthma: T lymphocytes, mast cells and eosinophils. These cells are responsible for the body’s normal defence and their activity is increased in asthma. Medication for asthma attempts to regulate this activity.
According to the degree of restriction, the person affected will experience breathing difficulty and a sensation of lack of air. Also characteristic of asthma are wheezing, which is the sharp whistle-like sound of the air as it passes through the smaller airways, and increased bronchial secretion.
Asthma can affect all age groups and sometimes overlaps with bronchitis. On many occasions it can be allergic in origin or come as a result of exposure to an environmental or chemical agent.
Spirometry, chest x-ray, allergy tests.
Some basic questions for diagnosis:
1) Have you ever had a whistling sound in your chest?
2) Have you been coughing, especially at night?
3) Have you had a cough, whistling sound, difficulty breathing at some times of the year or in contact with animals, plants, tobacco or whilst at work or after exercise?
4) Have you had colds that last more than 10 days or are "chesty"?
5) Have you used inhaled medication?
Treatment is based on using bronchodilators, in the form of an inhaler or tablets. Anti-inflammatory drugs also have an important role.
The most common diagnostic tests for asthma are based on:
1) Spirometry: Measures air flow on inhaling and exhaling and detects any restrictions in the airway, one of the characteristics of asthma.
2) Bronchodilator test: Tests if spirometry improves with drugs to dilate the airway.
3) Bronchial challenge test, the same test in the opposite direction with drugs that cause a slight airway obstruction, detected by spirometry.
To prevent asthma, it is fundamental not to smoke and avoid exposure to allergens that precipitate it, which are detected with the allergy tests that form part of the asthma exam.
The Inherited Heart Disease Unit is basically devoted to providing care. We have a team of two cardiologists, three interns and two nurses, one full-time and one part-time. This Unit addresses all myocardiopathies in general, and inherited cases in particular.
Myocardiopathies are diseases where the myocardium is weak, dilated or has some other structural problem. Often, the heart is unable to pump or work properly. In the case of inherited myocardiopathies, due to the fact they are often treated as part of uncommon diseases, specialist management is not within the scope of all clinical cardiologists. It requires specific treatment and involves specific technology.
We promote day surgery as it is an increasingly common alternative to traditional hospital admissions and is more convenient for patients. The facilities, technology and running of the whole centre are focused on maximising this kind of walk-in surgery.
How to get there
Vall d’Hebron’s Day Surgery Unit (UCSI), currently situated in the Pere Virgili Major Outpatient Surgery and Rehabilitation Centre, offers an alternative to the usual hospital admissions process. The 2,330 m2 Unit boasts the latest cutting edge technology, and facilities designed specifically with ambulatory surgery in mind. The centre has 6 operating rooms, 3 surgeon’s offices and 4 outpatient rooms for nursing, anaesthesia and surgical specialities. The unit currently performs over 13,700 procedures a year.
Whilst always under supervision, all patients can return home to continue their recovery a few hours after treatment. This surgery service is focused on convenience for patients, so they can recover in their normal environment without having to be admitted to hospital.
The surgical teams at the Day Surgery Unit come from other departments and units at Vall d’Hebron. Ambulatory surgery related to various parts of the Hospital is currently carried out here, such as General and Digestive Surgery, Maxillofacial Surgery, Dermatology, Ophthalmology, Otolaryngology, Urology and Vascular Surgery from the General Hospital; Orthopaedic foot, ankle, hand, shoulder and knee surgery, and Plastic and Reconstructive Surgery from the Traumatology, Rehabilitation and Burns Hospital; and Gynaecological Surgery, Fertility and Breast Disorder Surgery from the Maternity and Children’s Hospital.
The Day Surgery Unit also actively participates in specialised medical training through the Resident Medical Intern (MIR) programme in the different surgical specialisations.
The General Hospital offers all the medical specialities for adults, and has a proven track record. Patient care is comprehensive and essential in the process of identifying the causes of the disease and its treatment.
We are a level 3 hospital, which means that we specialise in severe, acute and critical patients and we handle clinical cases with the highest degree of severity and complexity.
We handle 1.2 million patients a year, many of whom also have the option to take part in clinical trials run by our research teams. This proximity between the labs and the hospitals gives us added value. The fluidity between research and care thus allows us to translate the knowledge from research and care into improving patient health.
We are also a reference hospital for various accreditations. You can view them here.
Bone marrow is a diffuse organ present in the small cells of the bones and which contains the stems cells which form the cells that circulate in the blood. Accessing this part of our bones can provide information about blood precursor cells, and also tell us if there are any unusual cells or microorganisms of an invasive nature.
This test is used to see all stages of blood cell maturity, both for diagnosis and to evaluate the response to treatment in neoplastic disease.
It is also used to rule out or confirm the presence of cells that should not normally be present.
With local anaesthesia for spinal cord aspiration and under sedation for bone marrow biopsy. A puncture and aspiration of a bone area rich in precursor cells is performed.
Bone marrow aspiration can be done both in the sternum bone and in the iliac crest (back of the pelvis). A bone marrow biopsy can be performed in the iliac crest. A sample of bone tissue and marrow blood is taken from these areas through the puncture.
The procedure lasts between 10 and 15 minutes, after which the puncture site is strongly compressed for a few minutes and a dressing is applied, which must be removed after 24 hours.
It is necessary to bear in mind that, until 24 hours after the test has been conducted, no effort or weight should be put on that area. After this time, you can lead a normal life. In the event of pain or discomfort, pain killers can be taken.
An exposure test is the controlled administration of a medication or food to diagnose allergic reactions.
Controlled exposure testing with foods or drugs is used for confirming or ruling out allergic reactions, when a conclusive diagnosis could not be reached with the other tests.
The first thing that has to be done when carrying out a controlled exposure test is inform the patient about the test, its usefulness and associated risks. Patients should be provided with an information sheet and asked to sign an informed-consent form.
The tests are carried out in the nursing office, located on the second floor of the Old School of Nursing (Antiga Escola d'Infermeria), where a nurse will carry out the skin tests and some food and medication challenges, or at the Allergology Day Hospital, which has all of the tools for diagnosing and treating any adverse reaction, as well as a doctor and nursing staff who are trained to carry out this procedure.
With drug trials, allergen will be administered through the safest route (orally or intravenously). When necessary, the dose will be divided or the speed of administration reduced, according to the documented adverse reaction and the type of drug being studied.
Once the drug has been administered, patients should remain under observation for several hours so that any delayed reactions can be diagnosed.
Since the procedure is not without risks, the risk-benefit ratio needs to be assessed before an exposure test can be carried out. As for studies with medications, such testing will only be done with important drugs, meaning, in cases where one medication is more effective than other alternatives (if there are any).
Most reactions triggered by the test are mild, and then diagnosed and treated early. However, severe reactions can occur, such as anaphylaxis and anaphylactic shock.
There are no alternatives to exposure tests, since they represent the last stage of a diagnostic process. However, if a diagnosis can be obtained from the previous tests (skin or blood testing), it may not be necessary to carry these out.
Skin tests are important procedures to confirm allergic sensitisation mediated by immunoglobulin E (IgE) antibodies in patients who suffer from rhinoconjunctivitis, asthma, hives, anaphylaxis, atopic eczema or allergies to foods or drugs.
Skin tests are ordered when there is a suspected allergic reaction or disorder after t a medical history has been taken (through questions) and the patient examined. Skin tests, thus, give us an objective confirmation of sensitisation to an allergen, although the relevance of that sensitisation has to be interpreted with the patient’s history borne in mind, so that the appropriate advice on avoidance and treatment can be given.
There are two main types of skin tests:
The results are read after 15-20 minutes. If the patient is “sensitised”, the substance will induce a local reaction with itching, redness, swelling, etc. This reaction is compared with tests done with physiological serum (negative control that should not cause a reaction) and histamine (positive control that should cause a reaction).
The patient should not take antihistamines (anti-allergy medications) for 5-7 days prior to the test.
The risk with these tests is very low. Only in extremely allergic patients, and usually while testing medications, is there a certain risk of their causing a serious and generalised allergic reaction.
In some cases, blood can analysed to assess its sensitisation.
This test is used for assessing secondary involvement in this disease and ruling out similar processes. It may also help to find trapped peripheral nerves that usually result from overloading of the joints and, in particular, the upper limbs.
For helping to confirm diagnoses.
Through electrical stimulations with surface electrodes and electrodes inserted into muscles with very fine needles.
Secondary pain during the procedure and a little bleeding (haematoma).
There are no other techniques that can replace EMGs in diagnosing poliomyelitis and post-polio syndrome.
Skin tests are the technique most commonly used to begin diagnosing an allergy. Following a meticulous clinical history, it is decided which skin tests may be useful, depending on the case.
Skin allergy tests serve to find out if a patient is "sensitised" to a particular substance, if their body recognises the substance and reacts when it comes into contact with it. These tests DO NOT DIAGNOSE an allergy. They are only positive if accompanied by one of the symptoms compatible with an allergy, helping a diagnosis to be reached.
There are two main types:
The risk of these tests is very low. Only in extremely allergic patients and usually with drug testing, there is a certain risk of serious and widespread allergic reaction.
In some cases, blood tests can be conducted to assess blood sensitisation.
Blood smear - making a small prick in a finger in order to assess cell morphology. This prick is used to conduct a morphological examination of blood cells, allowing a first approximation and examination of possible diagnoses.
A blood smear or peripheral blood test is performed by obtaining a blood sample through a finger prick (a puncture in the fingertip with a very fine needle) or a venipuncture (extraction from a vein), and carefully spreading a drop of blood on a glass slide until it forms a very thin film. The cells are then stained and the morphology of the cells is analysed under an optical microscope.
Microscopic study of a peripheral blood smear allows the cells present in the blood sample to be seen directly and their morphological characteristics analysed (shape, size and cell organelles such as the nucleus or granulation characteristic of some cells, and also inclusions, deposit of substances, and even microorganisms such as parasites or bacteria).
Using this test, we can check if the cells have a normal or altered appearance. If any alterations are detected, they can be described and an overall interpretation of the exam can be drawn. This allows the suspicion of various diseases to be ruled out or confirmed, both blood and non-blood-related conditions. It also allows observation of the effects that other conditions within the body have on blood cells, such as infections, haemorrhages, trauma, etc.
If the blood smear suggests the presence of a blood or bone marrow disease, it may be necessary to conduct bone marrow aspiration and/or biopsy to confirm the diagnosis.
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