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Rheumatology, Traumatology, Rehabilitation and Burns Hospital
At the Internal Medicine Department, we offer comprehensive internal medicine care to adult patients in our region, both at the Hospital and in Primary Care. We are a leading point of reference in both Catalonia and Spain in systemic autoimmune diseases. In addition, the Ageing and Chronic Patient Section covers Geriatrics and coordinates and collaborates with social-healthcare provision throughout the region.
The Internal Medicine Department is the cornerstone of medical care at Vall d'Hebron University Hospital. It is key in providing support to the other medical and surgical departments and the Accident and Emergency Department.
Systemic autoimmune diseases are the main specialty of the Department. We have more than 30 years’ experience in these illnesses and are a leading centre in both Catalonia and Spain as a whole. In terms of care, teaching and research our professionals are leaders in diseases such as systemic lupus erythematosus, scleroderma, dermatopolimyositis, systemic vasculitis, Sjögren's syndrome and Behçet's disease. We have a multidisciplinary team of professionals offering expert, personalised care for patients with these diseases, both in diagnosis and in treatment and subsequent follow-up at the Outpatient Clinic. We also offer support to the Obstetrics Department in the management of pregnancy for women with these diseases and with primary antiphospholipid syndrome.
The Vascular Risk Unit is a leading point of reference in the diagnosis and treatment of dyslipidemia and arteriosclerosis and their complications, and collaborates with all the other hospital departments involved in the management of these patients.
The Ageing and Chronic Patient Section is made up of the Geriatrics Unit of the General Hospital and the Orthopaedics Unit of the Hospital of Traumatology. This Section, in collaboration with the Primary Care Section, has recently inaugurated a new centre for chronic care (Chronicity Integral Support Team, or ESIC) that is located in the Casernes building in Sant Andreu, whose mission it is to bring the hospital expertise closer to the patients, thus avoiding unnecessary hospital trips and hospitalisation. This pioneering section is but the start of a whole network of such centres in the city of Barcelona and surrounding areas.
The Ageing Division coordinates and collaborates with centres for subacute patients and social-health centres in our region, in particular with the Pere Virgili Health Park.
The ultimate goal of our entire organisation is to ensure that the patient is at the heart of every action taken, to ensure continued care both in Primary Care and in our Hospital, as well as after the patient has been discharged.
The Departmental Research Unit, which is part of the Vall d'Hebron Research Institute (VHIR), brings together basic research projects in immunology, systemic autoimmune diseases and ageing from the various Departmental teams, and participates in national and international clinical trials, and projects with public and private funding.
In terms of teaching, it is the mission of the Internal Medicine Department to help train doctors at the Vall d'Hebron Teaching Unit of the Autonomous University of Barcelona, to train residents in internal medicine and geriatrics and to train Postgraduate and continuing education students in systemic autoimmune diseases and in clinical gerontology.
The Allergology Department treats patients with allergies, a very common pathology that now affects approximately one in four people.
At the Allergology Department, our mission is to provide care for people with allergy-related diseases and to improve their quality of life, in accordance with their needs and wishes. The key to achieving this is comprehensive care. We work hard to provide faster, reliable diagnoses and offer personalised treatments.
The diseases that we treat in our Department include: respiratory allergies (asthma and rhinitis), food allergies, allergy to medications as well as skin diseases, such as hives, atopic dermatitis and contact dermatitis. Often, a patient can present more than one of these diseases or problems, meaning it is important that a single professional be able to assess them jointly.
We also deal with "rare" pathologies, mainly hereditary angioedema, which is a disorder that causes inflammation of the face and the respiratory tract, as well as abdominal cramps; systemic mastocytosis, which is a disease of the blood or haemopathy; eosinophilic oesophagitis, which is an inflammation of the oesophagus wall, and allergies to hymenoptera poisons (insects such as ants, bumble bees, wasps, and others).
At our Department, we work in accordance with the Health Department's Allergy Care Model. As a reference centre in our region, we provide care for complex allergy-related pathologies, which requires appropriate infrastructure to carry out diagnostic risk tests, such as tests for allergies to medication, foods, hymenoptera or occupational respiratory allergy, meaning allergies acquired at work. We also possess the necessary allergies laboratory, with specialist staff and equipment, in order to diagnose allergies.
Tests involving a certain level of risk are carried out at the Day Hospital, where the necessary resources are available to deal with any possible adverse reactions. These tests are mainly used to diagnose allergies to medication.
The Allergology Teaching Unit is led by allergy and immunology professionals from the Internal Medicine Department (General Hospital), and from Paediatric Allergies from the Respiratory Medicine, Cystic Fibrosis and Allergy Department (Maternity and Children's Hospital). The Unit’s healthcare activities are divided into outpatient clinics, the day hospital and medical interconsultations. We were the first to use molecular diagnostics for complex allergic conditions in Catalonia and we are the leading centre for rare disorders such as hereditary angioedema and systemic mastocytosis.
Allergology training itinerary
The Allergology Unit has been training residents since 1982, and is where most heads of allergology divisions in Catalonia did their training.
We attend to outpatients regarding allergic respiratory disease, paying special attention to asthma, complex food allergies, hymenoptera allergies, chronic urticaria, atopic dermatitis, and drug allergies.
The Day Hospital carries out controlled drug exposure tests and chemotherapy and other drug desensitization therapies. The paediatric unit carries out food desensitization therapies. We also deal with hospital consultations on a daily basis.
The unit carries out clinical research in the fields of anaphylaxis, hereditary angioedema, food allergies and chronic urticaria. In terms of experimental research , we offer the opportunity to carry out specific immunoglobulin E and G tests by biochip, and basophil activation tests. Five doctoral theses have been supervised by the Unit and all its staff physicians are qualified Doctors of Medicine.
Why specialise at Vall d’Hebron?
The Internal Medicine Teaching Unit is led by the Internal Medicine Department and its various care units (General Internal Medicine, Hepatology, Autoimmune System Diseases, Infectious Diseases), with participation from the Cardiology, Respiratory Medicine, Neurology, Haematology, Oncology, Intensive Care Medicine and A&E Departments.
Internal Medicine training itinerary
Internal medicine is a core medical speciality that is practised primarily in hospital settings, providing comprehensive care to sick adults. It uses a medical approach in the prevention, diagnosis, therapeutic indication and follow-up of diseases in adults, including during their rehabilitation and palliative care. Internists are the backbone of the hospital, offering their versatility in acute and emergency hospitalisation; carrying out consultancy roles in primary care; and offering innovation in areas other than conventional hospitalisation and in the socio-health field.
The teaching unit is made up of 3 different departments. These include the Internal Medicine Department, which is broken down into the Systemic Autoimmune Disease Department, the Internal Medicine - Hepatology Department and the Infectious Disease Department. The Internal Medicine department is made up of different units which independently treat patients suffering from complex pathologies (Pleural Unit, Thromboembolic Diseases Unit, Autoinflammatory Diseases Unit and the Autoimmune Diseases unit).
In daily practice, resident medical staff visit patients together alongside specialist physicians. During these visits, medical records are drawn up and physical examinations are carried out. Visits can also entail clinical ultrasounds, diagnostic-therapeutic examinations (thoracentesis, paracentesis, arthrocentesis, liver biopsy, etc.) as well as differential diagnoses and the provision of diagnostic guidance. The pertinent examinations are requested and the treatment is duly adjusted.
During the IMR training, internal medicine residents learn how to diagnose and manage the most commonly found diseases on hospital wards and in internal medicine consultations. They will also learn about the most commonly treated pathology in other medical fields, obtaining a comprehensive and multi-disciplinary training that will allow them, upon the completion of their residency programme, to tackle a wide range of clinical scenarios with complete independence.
Moreover, in terms of specific areas of interest, residents will learn how to manage immunosuppressive therapies and patients suffering from cirrhosis, HIV and nosocomial infections, amongst other pathologies.
On-duty shifts are carried out in the A&E department in combination with inpatient care, preparing the Internal Medicine resident to treat critically ill patients in a fully independent manner upon the completion of their IMR training. It should be noted that residents treat patients suffering from a broad range of medical pathologies, meaning experience is gained in the management of patients suffering from conditions such as shock, respiratory failure (intubation and mechanical ventilation) and cardiac arrest.
Healthcare, teaching (sessions) and research tasks are carried out on a daily basis in all Internal Medicine departments. The Internal Medicine IMR will be progressively incorporated into these sessions, and will also participate in the research groups of his/her interest.
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