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.
These syndromes are a group of diseases characterised by insufficient blood cell production (anaemia, neutropenia and thrombocytopenia), constitutional malformations and the risk of cancer.
They are usually diagnosed in childhood but there some cases diagnosed in adults. Specifically, these syndromes are: Fanconi anaemia, dyskeratosis congenita or selectively severe congenital neutropenia, Diamond-Blackfan anaemia, Diamond-Shwachman syndrome, and amegakaryocytic thrombocytopenia.
Malformations caused by inherited bone marrow failure syndromes affect the skin, bones, heart and digestive system as well as the urinary system, the central nervous system, and others. They may also affect the area around the bone marrow.
Besides this, they also increase the predisposition to cancers such as acute myeloid leukaemia, myelodysplastic syndrome and squamous carcinoma of the head, neck and reproductive organs.
These syndromes have important biological pathways in common related to cell growth and division such as the activation of the p53 gene that is responsible for halting the cell cycle, cell ageing and cell death. In addition, mutations have been identified in more than 80 genes.
Although this is treated in childhood, once the patient reaches adulthood monitoring is very important. Early diagnosis of these syndromes is essential to ensure the patient receives appropriate treatment. The aim is to minimise toxicity at the same time as allowing genetic counselling, and implementing strategies for cancer prevention and monitoring. This treatment should focus on treating the bone marrow failure, but also any constitutional malformations and extra-haematological manifestations, in addition to cancer treatment.
A multidisciplinary team of specialists with extensive experience of these diseases is necessary to ensure optimum patient care.
The first symptoms are related to a lack of blood cell production:
There are also signs related to malformations such as:
Estimated incidence rates of the different syndromes are:
The usual tests to detect inherited bone marrow failure are:
The following methods are used to treat these pathologies:
To prevent these diseases it is important to avoid smoking, alcohol, sun exposure, and to have a balanced diet. In addition, a cancer prevention programme should be followed with regular visits to the Cancer Prevention Unit and the Ear, Nose and Throat, Maxillofacial and Gynaecology departments.
The disease caused by the Zika virus is contracted by a bite from an infected mosquito, as in the case of dengue fever, chikungunya and yellow fever. It can also be spread through sexual intercourse, pregnant women may transmit it to their children, or through blood transfusions. In Europe there are no cases of infection by mosquito; all cases have been imported.
It is disease lasting a short time that can be overcome without complications or the need for admission to hospital. However, there is a relationship between this infection and some neurological disorders. In addition, pregnant women who are infected may give birth to babies with microcephaly.
The incubation period in humans is 3-12 days, up to 15 maximum. Although on many occasions there are no symptoms, when there are the disease is characterised by:
Since 2015, 71 countries have declared transmission of the Zika virus via mosquitoes. In addition, 13 more have stated that the disease has arrived by other means, generally through sexual contact.
In Europe, most cases have been imported from countries where it is endemic, mainly from Latin America but also from South East Asia. In Catalonia in December 2016, there were 150 registered infections, of which 32 were pregnant women.
Between the first seven to ten days of the disease, diagnosis is made using molecular biology techniques (RT-PCR) in blood and urine to detect the virus.
After this period, Zika disappears from the blood and is detected through antibodies in the serum.
There is no specific treatment for this disease. Symptoms generally disappear between three and seven days after infection. They are therefore lessened with analgesics and antipyretics.
There is currently no vaccine for this virus. For this reason, prevention is based on avoiding mosquito bites in countries where it is endemic, as well as using protection during sexual intercourse.
In the case of Catalonia, the risk is associated with the arrival of travellers from countries where it is endemic. Here there is a screening programme for pregnant women and their partners; they are a sensitive group as the virus may be passed to the foetus.
Pulmonary atresia with ventricular septal defect is a rare heart condition characterised by a lack of connection between the right ventricle and the pulmonary arteries.
This is a rare congenital heart defect characterised by no connection between the right ventricle and the pulmonary arteries. It is an extreme type of Tetralogy of Fallot in which blood enters the lungs to be oxygenated by bypassing the heart.
Blood can reach the lungs via the pulmonary arteries themselves, which are not connected to the heart, or via the collateral arteries, which originate from the thoracic aorta and directly supply the lung. There are significant anatomical differences between vessels which must be studied in each individual child.
This condition is very heterogeneous, which creates the variability seen in the pulmonary arteries. Two groups can be distinguished:
The prognosis of this disease depends on the growth of the pulmonary arteries to be able to surgically repair the condition.
It is a rare congenital heart condition which makes up 1-2% of all congenital heart defects.
In most cases, diagnosis is via foetal echocardiogram. This ultrasound will show the lack of connection between the heart and the pulmonary arteries, as well as the presence of VSD. Through this test the size and position of the pulmonary arteries can also be measured.
When a child is born, it has a certain quantity of oxygen, known as “saturation”, in its blood which is around 80-90% of the normal level, although this is enough for the child to develop normally.
The Ebola virus disease (EVD) is a serious infectious disease originating in wild animals. It is caused by a virus of the “Ebolavirus” genus (filoviruses) that tends to occur as outbreaks with a mortality rate of 50%.
The first symptoms are sudden onset of fever, muscle pain, weakness, headache and neck ache. These are followed by vomiting, diarrhoea, decreased function of the kidneys and liver, skin eruptions and haemorrhaging.
In the final phase of the disease, patients experience multiple organ failure which, in some cases may be overcome in the second week of the virus’ evolution and in others may cause death.
It is a contagious disease from the onset of symptoms.
It is a common disease in West and Central Africa. The biggest outbreak occurred in 2014 and resulted in over 11,000 deaths (Guinea, Liberia and Sierra Leone).
The incubation period ranges between 2 and 21 days.
In humans it is transmitted through direct contact with the blood and body fluids of infected people and with objects contaminated with infected patients’ body fluids. It can also be spread through sexual contact up to three months before any sign of symptoms.
It is essential to consider patients’ prior travel epidemiology and contact with others. Definitive diagnosis is carried out in laboratories in specialist centres, where the viral nucleic acid can be detected in biological samples. Before establishing an EVD diagnosis, other infectious diseases should be ruled out such as malaria, typhoid fever, dengue or meningitis.
As yet there is no specific treatment to combat the disease. It is important to keep patients well hydrated and maintain their arterial pressure, as well as provide to other essential life support.
Ebola prevention is based on different strategies:
A vaccination that has shown excellent results is currently in the approval stage.
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.
The treatment for suspected testicular tumours is the surgical removal of the affected testicle. Surgery is an important part of the diagnosis and treatment of testicular cancer.
Radical orchiectomy consists of the surgical removal of one or both affected testicles via the inguinal route, followed by an anatomopathological analysis to identify the type of tumour. This information will help the medical professionals to choose the most appropriate form of treatment for the patient.
After surgery, some patients may require treatment with chemotherapy or radiotherapy, which generates an excellent response in the vast majority of cases. These treatments are often prescribed after surgery in order to target remaining cancer cells that may have spread to other parts of the body, such as lymph nodes.
A detailed initial extension study, appropriate early treatment and strict follow-up are the pillars that help to ensure high survival rate and quality of life for these patients.
Patients with localised cancer may be treated with curative intent, primarily surgery or radiotherapy in its various forms. However, these radical treatments are not harmless and can cause side effects that affect the quality of life of the treated patient, such as erectile dysfunction, urine leakage and/or digestive disorders.
Not all prostate tumours are highly aggressive or impact the patient’s survival. Some do not even affect quality of life. These are low or very low-risk rumours, which are not very aggressive and not very large in size. They can be controlled without the need for immediate active treatment, albeit with close monitoring.
This is the surgical procedure by which the prostate gland is removed. In this operation, the urologist removes the entire prostate and seminal vesicles. In some cases, nearby lymph nodes are also removed at the same time. The use of the DaVinci robotic system and the minimally invasive approach means that this procedure can be performed with greater accuracy and excellent results.
In this treatment, ionising radiation is administered from a source of external beam radiation that is integrated into devices called linear accelerators. The radiation is modulated and applied directly to the prostate, protecting the nearby organs (bladder, rectum and urethra) as far as possible.This consists of various treatment sessions that take place in the hospital on an outpatient basis.
In case of disseminated disease, treatment is based on the suppression of testosterone, new hormone molecules and chemotherapy depending on the stage of the disease.
The goal of treatment is to increase the amount of oxygen that the blood can carry. This is done by increasing the number of red blood cells or the concentration of haemoglobin, a protein in red blood cells that is rich in iron and carries oxygen to the body's cells. In addition, the underlying disease or the cause of the anaemia, where there is one, needs to be treated.
Treatment of anaemia depends on the type, cause and severity of the disease.
It may consist of:
Your doctor may determine the need for a blood transfusion or other more complex procedures.
A transfusion of blood and/or blood products consists of replacing the blood components that are vital for the patient's survival: red blood cells, platelets and plasma, which cannot be replaced by other alternatives.
This treatment is indicated in patients who, at a given time, are lacking in essential blood components and require the balance to be corrected as soon as possible.
Transfusions carry risks and the decision to transfuse must always be taken by a doctor, depending on the patient's condition, test results and an assessment of the situation. Patients will always need to sign a permission document, which is called informed consent.
Blood and blood components are obtained from voluntary donors. Before donating blood, donors are required to complete a questionnaire about their health status and must also undergo a medical examination. All the blood components obtained are then analysed to rule out the existence of diseases that may be transmitted through the blood.
Before the transfusion is performed, it should be checked that the blood product is compatible with the sick person's blood. The relevant medical staff must assess the risks and benefits of the treatment for the patient.
All components are administered through a vein using a venous catheter.
Although blood transfusion is currently very safe, some adverse effects may occur:
Currently, the transmission of blood-related infectious diseases is highly unlikely. All units of blood are tested for their blood type and to prevent the transmission of infectious diseases such as syphilis, hepatitis B, hepatitis C, HIV, Chagas disease and human T-lymphotropic virus infection.
Desensitisation is one of the treatments available for inducing temporary or permanent tolerance by repeatedly administering to patients repeated doses of the allergen causing them problems. It is a commonly used procedure for treating allergies to some medications and foods.
Desensitisation consists of administering, under controlled conditions, increasing doses of the allergen the patient is sensitised to, to make them tolerant of the medication or food that causes them problems.
This usually induces temporary tolerance, which means the patient can receive treatments they were originally allergic to, instead of having to take less effective alternatives. In the case of foods, patients may become completely tolerant to them or gain some protection against accidental ingestion of the allergen.
Patients undergo desensitisation treatment under the care of an allergist, at the hospital.
There is a risk of allergic reactions during the procedure.
Immunotherapy is a long-term, preventive treatment that aims to reduce the symptoms of patients diagnosed with hay fever, allergic asthma, conjunctivitis, or allergies to insect stings.
The objective of immunotherapy with allergens is to change the allergic response by inducing immunological tolerance. A patient with allergies has symptoms when they are exposed to the relevant allergen. Immunotherapy uses a larger quantity of the allergen, in combination with a different route of entry into the body. This modifies the immune system's abnormal response, causing it to develop a tolerance to the allergen instead of inflammation and allergic symptoms.
Immunotherapy was originally administered by subcutaneous injection.There are currently liquids or fast-dissolving tablets that can be used in sublingual immunotherapy for certain allergens.
Subcutaneously injected treatments are administered every 4 or 8 weeks; sublingual treatments must be administered daily. This is generally continued over a period of 3 to 5 years. Many patients experience a prolonged protective effect after that period, so an assessment may be made of stopping the immunotherapy.
Immunotherapy is indicated for patients with allergic rhinoconjunctivitis or allergic asthma who:
Immunotherapy with hymenoptera venom is indicated for individuals who experience a severe generalised reaction to bee or wasp stings.
Immunotherapy is generally safe and well tolerated when used in suitably selected patients. Even so, localised and generalised reactions can occur.
The most frequent reactions are localised ones, such as redness or itching at the injection site. These reactions are most likely to occur during the first administration of the treatment, which is why immunotherapy starts at the Allergology Department and, if well tolerated, can be continued on an outpatient basis.
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