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.
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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.
Flu is an infectious respiratory illness caused by the influenza virus, of which there are three types (A, B and C) and various sub-types. It is an illness that can present in a wide range of clinical forms: from asymptomatic infections to respiratory pictures that may undergo complications. The flu viruses circulate during the winter months in Spain, producing seasonal epidemics. The flu viruses that circulate each season do not have the same pathogenicity and different people's susceptibility to the viruses is not the same. The intensity of flu epidemics therefore changes year on year, both in terms of the number of people affected and with regard to the clinical picture of the infections. Anti-flu vaccination is the most effective primary prevention measure to prevent flu and its complications.
Flu is transmitted from an ill person to another person through droplets expelled when coughing and sneezing. The transmission period starts from the day before symptoms appear and persists for five days afterwards.
It is estimated that seasonal flu may affect between 5% and 20% of the general population, and that approximately 25% of febrile respiratory processes may be produced by the flu. This increased morbidity gives rise to a large number of medical consultations and absences from work as a consequence of the disease. Moreover, some people, such as older people, those with chronic illnesses, immuno-suppressed people and pregnant women, among others, may suffer more from the illness and it is common for them to experience complications during its evolution. Flu thus continues to be a major public health issue.
Flu presents heightened fever, dry cough, headache and neck ache, muscle pain and general illness. It can also cause diarrhoea, nausea and vomiting, especially in young children. In most cases, people recover in 7-10 days.
Flu may affect anyone, but the most vulnerable to suffering complications are children under the age of 2, people aged 60 or above, pregnant women, morbidly obese people and people of any age who suffer from one of the following types of illness: cardiovascular, pulmonary (including bronchopulmonary dysplasia, cystic fibrosis and asthma), neurological, neuromuscular, metabolic (including diabetes mellitus), kidney failure, immunosuppression, cancer, chronic liver diseases, asplenia and iron deficiencies.
Flu diagnosis is normally clinical and does not require laboratory tests. Despite that fact, microbiological diagnosis is fundamental to be able to obtain aetiological confirmation in patients with risk factors and those with serious illnesses. The detection of the virus in respiratory samples can be done using cultures, antigen detection techniques and molecular methods.
There is no specific treatment for flu. Treatment with analgesics and antipyretics (paracetamol) is recommended to alleviate or treat some of the symptoms associated with flu, such as fever or headache.
Antibiotics do not cure the flu. Only in cases where there is an overlying bacterial infection, such as pneumonia, or in those with chronic illnesses, may preventive antibiotic treatment be indicated to avoid complications.
Antivirals, such as oseltamivir or zanamivir, may be indicated in people at high risk of complications to reduce the duration of the flu and the possibility of complications, but they should begin to be taken within 48 hours from the outbreak of symptoms.
The best way of protecting yourself from the flu is vaccination and following good hygiene practices to prevent the spread of the virus. The purpose of anti-flu vaccination each year is to generate protection against the flu viruses that circulate in the flu season. Health authorities and scientific associations around the world unanimously recommend seasonal anti-flu vaccination for people at high risk. Anti-flu vaccinations are very safe and well-tolerated with effectiveness that ranges from 30% to 70% to prevent hospitalisation due to flu and pneumonia. In older people living in institutions, vaccinations have proven to be between 50% and 60% effective to prevent hospitalisation or pneumonia, and 80% to prevent death by flu.
It is a chronic inflammatory disease of the oesophagus caused and prolonged due to an allergic reaction. It is typified by difficulty swallowing (dysphagia) any food blockages in the oesophagus (food impaction) and rupturing of the oesophageal wall (oesophageal perforation).
The most common symptoms are:
If the inflammation of the oesophagus and related symptoms are left untreated, they will continue from childhood to adulthood. This inflammation causes structural changes to the oesophagus by remodelling the tissue. This can lead to fibrosis and oesophageal stricture. This means functional deterioration that significantly affects the patient’s quality of life.
From the first recorded case in 1993, eosinophilic oesophagitis has been found to affect 45 out of every 100,000 people, and has an incidence rate of 3.7 cases for every 100,000 people a year. This makes it the most common cause of dysphagia, spontaneous oesophageal perforation and food impaction in young patients.
For appropriate diagnosis, a gastroscopy must be carried out to take multiple biopsies from the oesophagus, since inflammatory alterations can be distributed unevenly. This technique also allows the response to treatment to be assessed.
Endoscopic analysis of the oesophageal mucous membranes is not sufficient to reach a firm diagnosis, as 10-15% of patients will have normal results of a endoscopy.
Treatment for EoE is based on three alternative therapies:
Early diagnosis is important to prevent complications arising from EoE. Early treatment and clinical and endoscopic monitoring is also essential.
Sepsis is a potentially fatal condition that occurs when the body responds to an infection and attacks its own tissue and organs. On some occasions it produces organic dysfunction (for example, hypertension), which produces an anomalous response to infection and translates into a very serious medical condition.
Septic shock occurs when abnormalities in the circulation, cells or metabolism are so severe that they increase the risk of mortality. This can be identified by persistent hypertension that requires vasopressors to maintain arterial pressure and serum lactate levels. With these criteria, and even with the necessary volume replenishment, hospital mortality rates are over 40%.
Sepsis arises from an infection which changes the body and unleashes signs that may be associated with organic dysfunction or systemic hypoperfusion. These symptoms are:
Every year there are on average 212.7 sepsis patients for every 100,000 citizens in the Catalan healthcare system. To be precise, between 2008 and 2012, 82,300 people were diagnosed with severe sepsis and in 2012 there were 20,228 recorded cases.
At Vall d’Hebron, 232 patients were admitted to Intensive Care with this condition in 2010, amounting to 25.2% of all admissions to this department.
The following diagnostic tests are used for sepsis:
Early treatment can improve prognosis. Sepsis Coding is used for this reason:
To prevent this condition, early detection of patients with a history suggestive of infection and organic dysfunction is vital. In some cases, vaccination is necessary.
It is a cancer found in the bones and soft tissue. Ewing's sarcoma is the second most common cancer in children, and normally occurs between ten and twenty years old. It is also more common in males than in females. Ewing's sarcoma and primitive neuroectodermal tumours (PNET) are cancers encompassing different types of malignant tumours that share a common chromosomic abnormality. Ewing’s tumours are made up of small undifferentiated cells and tend to be most commonly found in the long bones of the leg or arm, in the flat bones of the ribs and pelvis, or in the spine. They may also occur in any other bone or in soft tissue.
Ewing's tumours located in soft tissue are called extraskeletal Ewing’s sarcoma. They tend to be found in the thigh, pelvis, parts of the spine, the chest wall and the foot.
Primitive neuroectodermal tumours in bones and soft tissue are the least common type of Ewing’s sarcoma. They are made up of immature nerve cells.
The most common symptoms of Ewing’s sarcoma are:
There may also be a lump or swelling around the affected bone or tissue. During diagnosis it is very common to discover a pathological fracture (a non-traumatic fracture) due the fact that the tumour has weakened the bone. Weight loss and fever are other very common symptoms of this kind of tumour.
Malignant neoplasms in children and teenagers are rare, but they are one of the most important causes of morbidity and mortality in these age groups. Ewing’s sarcoma represents 3 % of cancers diagnosed in children throughout Spain. Every year there are around 30 new cases in children under 14 years of age.
If a child shows symptoms of this sarcoma, the doctor will carry out several diagnostic tests which may include:
These tests will help to determine the size and location of the tumour and whether it has spread to other parts of the body.
Three kinds of treatment are often used to treat Ewing’s tumours. Chemotherapy is always used. In addition, surgery (whether to save or amputate the limb) and radiotherapy are used for local control of the tumour. The type of treatment depends on the child's age, the location of the tumour and whether it has spread to other parts of the body.
There are currently no measures to prevent this kind of tumour.
Constipation is a disorder of the bowel habits characterised by emptying the bowels less often or hard stools that are difficult to expel. It affects women more than men, and in most cases there is pain or abdominal discomfort. This condition has very important repercussions on the patient’s personal life, health and social life.
In most cases, the cause of constipation is unknown, with no organic or anatomical injury to explain it, and is defined as functional or primary constipation. In other cases, constipation is the result of certain illnesses or medications, known as secondary constipation.
There are several variants within primary constipation:
Secondary constipation due to taking certain medication, above all opioids for pain, and due to neurological, metabolic, or infectious diseases (Chagas) or cancer, amongst others.
The most frequent symptom is difficulty evacuating the bowels.
If there is an alteration in rectal evacuation, symptoms may be:
This is a very common condition in adults and children and affects 10-30% of the world population. 69% of patients say that it affects their performance at work or school, and 40% of patients with constipation have consulted a doctor at some time for this reason. In Spain, between 2005 and 2006, twenty-three million units of laxatives where prescribed in a year.
In general, there are no routine tests on patients with chronic constipation as long as there are no causes for concern such as fever, weight loss or rectal bleeding. On the other hand, if constipation has started recently with no apparent cause, or does not respond well to treatment, it must be investigated via different tests such as:
Constipation must be treated in a personalized way and the causes of it starting or worsening must be analysed. Dietary and hygiene habits and any medication being taken must also be looked into.
The lack of response to this treatment should be assessed by specialists.
There are several ways to prevent constipation:
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