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.
Prostate cancer is one of the most frequent cancers in the male population. This is the most frequent malign tumour in the male urogenital system and the second cause of death from cancer in men after lung cancer, with a mortality rate of 12%.
If there is any suspicion, due to symptoms or high PSA levels, a rectal examination will be performed along with a new serum PSA analysis. If the rectal exam is positive (if a nodule or hardening of the prostrate is detected) a biopsy will be carried out. If the rectal examination is negative, the PSA levels will be assessed, to determine whether to carry out a biopsy or not. The PSA is used as a filter for the general population, in order to enable early diagnosis of prostate cancer.
It is a good tumour marker, because it increases when the prostatic glands break down due to tumour growth. As it is also present in normal prostates and it also increases in the benign growth of the prostate, it must always be interpreted in each patient's individual context. An increase in PSA is not a synonym for prostate cancer, and a rectal examination and ultrasound scan should always be carried out. The final diagnosis is given only by a biopsy.
It is often asymptomatic and the first warning sign is high PSA levels. Patients may also present tiredness, loss of appetite and weight loss. Local alterations are also frequent: urinary obstruction, urinary retention, presence of blood in the urine, urinary infections. In the case of spreading, bone pain is frequent.
The typical profile is a male between 50 and 70 years old, in whom benign prostate growth may coexist.
Diagnosis of prostate cancer is carried out using serum PSA, rectal examination and an ecodirected prostate biopsy.
When prostate cancer is localised and low-risk, it can be treated through extirpation and radiotherapy. In the case of spreading, treatment through radiotherapy and hormones will be assessed, in order to stop tumour growth. Occasionally, if the patient is elderly, the development of the cancer will be closely monitored before extirpation, as in some cases, it poses no short-term threat to their survival.
Rectal examination, determination of serum PSA, prostate biopsy.
Survival rates for prostate cancer depend on the state at the time of diagnosis; it is quite favourable in local states, less so in advanced states and worse once it has spread. Periodic prostate evaluation by primary care doctors is therefore indicated.
Multiple myeloma is a type of blood cancer that originates due to an abnormal proliferation of plasma cells (one type of leukocyte, the body’s defence). These plasma cells can cause bone lesions, growing profusely and causing anaemia. At the same time, they are able to produce immunoglobulins. These are proteins that, in excess, can affect the kidneys and increase the risk of infection.
Multiple myeloma is a type of bone marrow cancer that comes about due to the proliferation of clonal plasma cells and the abnormal production of immunoglobulins (Ig), which are a component of the immune system and can be found in blood and/or urine.
The annual incidence in adults is 4-6 new cases per 100,000 of the population per year, which represents 1% of all cancers and 10% of blood cancers. These figures mean the condition is considered rare. It often affects predominantly older people, with the average being around 70 years.
Excess Ig interferes with the properties of the blood, affecting normal kidney function and increasing the risk of developing infections (as normal Ig are not produced). If there are also excess plasma cells, the bones containing bone marrow may be damaged, with possible fractures and pain. It can also make the normal production of red blood cells, white blood cells and platelets more difficult, leading to increased risk of anaemia, infection and bleeding.
The classic symptoms of myeloma are given by the initials of the affected organs: “CRAB” (Calcium, Renal failure, Anaemia, Bone lesions). These may, however, lead to other symptoms:
In a routine analysis, it is common to find a monoclonal gammopathy, anaemia or to diagnose a fracture after the persistence of bone pain that does not stop with conventional analgesia.
To confirm the diagnosis and establish the extent and treatment needs, a full blood count needs to be conducted with a special protein study, a urine analysis to rule out abnormal protein excretion by the kidneys, a bone marrow aspirate or biopsy to confirm excess plasma cells in the bone marrow (if possible with cytometric and genetic study) and imaging tests to rule out bone lesions.
Treatment of multiple myeloma has changed significantly in the last decade and above all in recent years with the appearance of new drugs and action mechanisms.
The aim of treatment is to control the condition for the longest amount of time possible with minimal side effects and to achieve a good quality of life.
Treatment of multiple myeloma includes drugs that can be classified according to their mechanism of action:
· Proteaosome inhibitors
· IMiDs
· Alkylating agents
· Corticosteroids
· Monoclonal antibodies
As well as the drugs and combinations used, a treatment plan may also take into account the possibility of one (or two) bone marrow transplants.
There is currently an exponential increase in the development of new treatments for multiple myeloma. New drugs are being developed with different mechanisms of action. In some cases, these new drugs or potentially beneficial combinations may be offered as part of clinical trials.
Suicide is a common cause of death. Every year, around one million people across the world die of suicide. It remains the biggest external cause of death in our country (Spanish National Institute of Statistics - INE, 2017). It is estimated that suicide attempts (SA) are 10-20 times more common than suicide. Within a broad spectrum of suicidal behaviour, we find highly lethal SAs (those which are closest to suicide).
Medically serious suicide attempts (MSSA) or highly lethal suicide attempts (SA) are characterised by the fact that they present a serious organ compromise, regardless of their psychiatric severity.
MSSAs, in the broad spectrum of suicide attempts, are the closest to consummate suicide, being two populations with overlapping characteristics. MSSAs also have greater risk of death by suicide compared to low lethality suicide attempts.
An important aspect to bear in mind is that assessing survivors of serious suicidal behaviour allows us to obtain information directly from the survivor, unlike consummate suicides, in which the assessment is performed indirectly through third persons (psychological autopsy). The fact that we are able to assess people so close to suicide is hugely valuable to find out more about the psychological mechanisms of serious suicidal behaviour and the warning signs, in order to avoid suicide.
In a large proportion of these people, a prevalence of psychiatric pathology has been observed. These mainly consist of affective disorders (depression), followed by personality disorders and other disorders related to the consumption of substances. There are also other socio-environmental, non-psychiatric risk factors that should be assessed: presence of serious/chronic medical pathology, functional limitations and their adaptation (people with some sort of physical disability or older people) and social support.
Most patients present clinical depression that does not always coincide with the presence of a stressful event. They may have a history of suicide attempts. Prior to the MSSA, they may have shown thoughts of wanting to die or a more structured idea of how they would commit suicide.
People with an unstable/untreated psychiatric disorder: Unipolar affective disorders (depression) may have a greater predisposition towards suicidal behaviour.
The presence of an underlying psychiatric disorder should be assessed and treated following an MSSA.
Once the patient has recovered from a life threatening situation, a comprehensive approach should be taken, focused on clinical and socio-environmental aspects. The presence of a psychiatric pathology should be assessed and treated. It is also important, following medical discharge, to refer the patient to the mental health network and activate the Suicide Risk Code, allowing follow-up after hospitalisation.
Medical and psychiatric history and psychological assessment.
Avoid the myths that proliferate the social stigma surrounding suicide and assess the presence of suicidal thoughts with clinical and socio-demographic risk factors.
Venous thromboembolic disease refers to the process characterised by the formation of a thrombus (blood clot) in the deep vein system that can grow or fragment, interrupting the normal circulation of blood and causing various alterations.
The main manifestations of thromboembolic disease are deep vein thrombosis (DVT) and pulmonary embolism. DVT occurs when a thrombus or blood clot forms inside a deep vein, usually in the legs (although it can also occur in the arms, abdomen, ilium, vena cavas, etc.), obstructing normal blood circulation in these veins.
A thrombus that forms in a deep vein can become fragmented or rupture and break off. The detached embolism travels through the veins towards the heart, reaching the lungs through the pulmonary veins. The clot stops in the lungs and obstructs the interior of one or more pulmonary arteries, preventing blood from passing. This process is known as pulmonary embolism (PE).
Vein trombosis:
- Swelling or inflammation of the affected leg
- Pain or sensitivity in the leg, often starting in the lower leg
- Increased temperature in the leg
- Changes in skin colour (reddened or bluish, shiny)
Pulmonary embolism :
- Shortness of breath or sudden onset drowning (dyspnoea).
- Increased breathing rate
- Increased heart rate
- Acute chest pain
- Dry cough with blood
- Loss of consciousness (syncope)
Incidence (number of cases/year) of venous thromboembolic disease in the general population, including any of its manifestations, is estimated to be between one or two cases for every 1,000 people in Spain. This means that there are more than 80,000 cases a year in Spain, with about 70% of these being deep vein thrombosis and the rest being pulmonary embolism.
DVT:
The patient’s symptoms are analysed, as well as conducting a blood test and imaging tests. The most commonly used test of choice is Doppler ultrasound (eco-Doppler), an imaging technique that allows the deep veins to be seen and confirms or rejects the diagnosis.
PE:
If suspicions point to a possible pulmonary embolism, the diagnosis will be confirmed using tests such as a chest CT (scan) or pulmonary scintigraphy.
When a clot is produced, whatever type it may be, the main aim of treatment is to dissolve the thrombosis and re-establish blood flow to avoid further complications.
Anticoagulants are the treatment of choice for venous thromboembolic disease. Anticoagulants are medication that modify blood clotting so that a thrombus or clot does not form inside the blood vessels, helping to break up clots that have already formed.
Laboratory tests such as D-dimer. Imaging tests such as Doppler ultrasound, CT and pulmonary scintigraphy.
THROMBOPHILIA BLOOD TEST in some cases, a blood test is also performed to determine if the patient has any alterations in their clotting proteins that may predispose them to thrombosis.
Knowing the risk factors of venous thromboembolic disease is crucial to be able to act and control this risk. One of the cheapest and most effective recommendations that helps to prevent possible thromboembolic episodes is walking, as moving around helps avoid clot formation.
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.
The Vall d’Hebron General Hospital is a leading centre offering a wide range of highly complex medical and surgical services for the care of adult patients. It also plays a key role in the transition from paediatric to adult care, ensuring continuity of care for patients with chronic or complex conditions previously treated by the Vall d’Hebron Children’s Hospital. Such coordinated care ensures patients can progressively adapt to the adult services, improving their quality of life and long-term medical follow-up.
We are also a reference hospital for various accreditations. You can view them here.
The General Hospital Surgical Block is one of the most modern and technologically advanced facilities in Catalonia. It has state-of-the-art operating theatres that incorporate high-precision imaging systems, robotic technology and tools for minimally invasive surgery. These facilities enable the medical teams to perform highly complex procedures with maximum safety and efficiency, reducing patient recovery times and minimising postoperative risks. The Surgical Block also integrates digital systems that facilitate coordination between specialities and efficient resource management.
The General Hospital Intensive Care Unit (ICU) is a pioneer in implementing the Smart ICU, a system that integrates connected medical devices and secondary use of data to improve the monitoring and treatment of critical patients. This innovation enables professionals to obtain real-time information on the patient’s status, optimise decision-making and personalise treatment to their clinical course. Thanks to this technology, complications associated with long ICU stays have been reduced and patient safety has been improved, favouring recovery and reducing hospitalisation times.
With the completion of the work on the Emergency Department, the General Hospital has concluded the roll-out of a new emergency care model based on speed and efficiency. The renovated facilities are designed to streamline patient flows, reduce waiting times and improve coordination between different departments. The space has new triage and observation areas, and technology to provide more structured and efficient care. This new model has transformed care for emergency patients, improving both the patient experience and healthcare professionals’ response capacity.
The General Hospital has implemented the One Step Ictus project, a pioneering initiative that optimises care for patients with ischaemic and haemorrhagic stroke. The model concentrates the whole approach to stroke in a single direct-access room, in which diagnostic tests such as CT scans can be carried out, fibrinolytic treatments administered and, if necessary, endovascular interventions performed. This reorganisation shortens the time between the arrival of the patient and the start of treatment, improving prognosis and reducing neurological sequelae. One Step Ictus puts the General Hospital at the cutting edge of care for this pathology, offering patients the best possible healthcare response.
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.
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