Breast Cancer Treatments: Mastectomy

Posted by Xanit Internacional Xanit Internacional | Posted in women's health | Posted on17-10-2018

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This week is World Breast Cancer Day, and we wanted to talk to Dr Fran Fernandez, Head of the Breast Unit at Vithas Xanit International Hospital, about one of the most common treatments for breast cancer – mastectomy. 

Mastectomy 

We treat cancer in several ways, but one of the most common methods is surgery. There are two types of operation depending on the stage of the disease. If the cancer is detectedin the early stages, the usual way forward would be the conservative surgery, which consists of removing the section of the breast with a tumour in it. In the caseof more advanced stages, the method we use is a mastectomy, which is the surgical act of completely removing a breast.

According to the protocols of preventive diagnosis of breast cancer, the percentage of mastectomy procedures is decreasing thanks to early detection through breast self-examination and radiological tests, depending on patient’s age, past medical and family history. Also, mastectomy can be avoided in those cases when we indicate chemotherapy treatments before the surgery. Experts recommend exercising regularly and eating a healthy diet to reduce risk factors, for a healthy body is more difficult to get sick.

Treatment 

The duration of breast cancer treatment can vary depending on the diagnosisand can range from simple surgery without further treatment, or those cases when the procedure can be prolongedfor up to 5 years. A good family environment is also necessary for a patient’s recovery. It is vital that the patient isadequately informedof the circumstances of their case and the options available. Some patients require the help of a psychologist and support groups, which can also play a vital role throughout the treatment. Besides, the patient can and should perform a physical exerciseto return to normal.

Risks 

Body imageis a critical psychosocial issue for post-mastectomy patients as they often undergosignificant changesto appearance and functioning. Changes in body image not rarely affect patient’s both intimate and social relationships. Other alterations that may occur are of sexual nature, chronic pain, lymphoedema or psychological sequelae,among others. We are fully aware of the impact post-mastectomy alterations may have on a patient, and we always advise our patients to be psychologically predisposed to overcome obstacles.

Fortunately, major, lethal complications are becoming less frequent. The current survival rate for breast cancer is nearly 85%, but we must continue to insist on early detection and new clinical trials toreduce the remaining 15%.

Cardiovascular diseases are the leading cause of death in Spain

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on04-10-2018

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Did you know that cardiovascular diseases are the leading cause of death in Spain? Today, Dr Gomez Doblas talks to us about these pathologies and their risk factors, offering us some advice on taking care of our heart.

Cardiovascular diseases represent 29.66% of the total number of deaths in our country, which places them above cancer (27.86%) and pathologies of the respiratory system (11.08%). Fortunately, they are also one of the illnesses that can be prevented the most, mainly by adopting healthy lifestyle habits.

Many risk factors can trigger cardiovascular related pathologies, such as obesity, arterial hypertension, cholesterol, diabetes, smoking, inadequate nutrition or sedentary lifestyle. Their prevention with multi-factorial strategies has shown that the development of cardiovascular illnesses we can avoid in 30% of cases. With that in mind, we would like to take the opportunity of the fact that World Heart Day has recently been celebrated to make particular emphasis on the importance of prevention since by following a few simple tips we can keep our heart healthy and prevent cardiovascular pathologies.

 

Some advice on taking care of our heart:

  • Doing sport regularly:Sport is one of the best methods to prevent health problems. Exercising reduces the risk of heart diseases and all types of cardiovascular illnesses. The practice of moderate exercise or sports activity along with the monitoring of other health habits has immediate consequences in the reduction of risk factors such as diabetes, arterial hypertension, arteriosclerosis, obesity and hypercholesterolemia. Sport lowers cholesterol levels in general and raises HDL (good cholesterol). It also benefits patients with type II diabetes by increasing the sensitivity of cells to insulin.

Besides, physical exercise improves the organic capacity of the heart, reducing our need for oxygen and lowering our blood pressure, so that we require the medication less and, at the same time, we improve the quality of our life.

Aerobic exercise is recommended between three and five times a week in sessions of no less than 30 minutes, controlling the heart rate to keep it within levels of moderate intensity. The most recommended physical activities are brisk walking or running at a gentle pace, bicycling, and swimming. We recommend that the intensity of these exercises should be moderate, involving and moving large muscle groups for the maximum benefits.

  • Following a healthy diet: A low consumption of dairy products is recommended (between 2-4 portions a day of skimmed or semi-skimmed products), using more olive oil as the primary source of fat, eating meat and meat products in small quantities, increasing, on the contrary, the consumption of fish and legumes as the main source of protein. It is also recommended to eat plenty of cereals (4-6 servings a day in the form of bread, rice, pasta – ), as well as fruits and vegetables. The consumption of salt and products rich in sugars must also be limited and, of course, we must not forget to drink at least 2 litres of water a day.

Performing sports will also help us in this task, allowing better control of caloric intake, which translates into a decrease in being overweight, producing a significant improvement in the quality of life.

Resolution on healthy lifestyle habits: Quitting negative habits such as smoking and reducing alcohol intake can also help us take care of our heart. Only by quitting smoking, for example, we can significantly reduce the risk of heart attacks and strokes.

  • Monitoring our heart regularly with medical check-ups:There is no specific “optimal” age to start caring for our heart. Even if we do not present any symptoms of cardiovascular diseases, we are still recommended to have a medical check-up of the heart from the age of 45-50. Furthermore, it is advisable to repeat the test every five years. Also, if we practice sports on a regular basis, we should perform the check-up a few years earlier, at the age of 40-45, and repeat it with the same frequency: a check-up every five years even if there are no symptoms. Professional athletes and people who regularly engage in high-intensity exercise should have a sports cardiovascular check-up.

Non-alcoholic fatty liver

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on20-09-2018

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Fatty liver occurs when there is an accumulation inside its cells of small droplets containing different types of fats(mainly fatty acids and triglyceride). It is a widespread pathology in the western world and in Spain, where it affects 25% of the population.

It can occurafter taking certain drugs, in people who consume significant amounts of alcohol (in which cases we call it fatty liver or alcoholic steatosis), but also in people who do not consume drugs or significant amounts of alcohol. It is in these latter cases when we use the term FATTY LIVER OR NON-ALCOHOLIC STEATOSIS.

 

 The causes are multiple

Although genetic predispositionis one of the causes of this pathology, it is not the only one, since other factors also play a role, among which we can highlight overweight and obesity, which fundamentally affects the increase in the abdominal perimeter. Fatty liver is a pathology that also develops especially in diabetic patients(more than half of the patientsdiagnosed with diabetes develop a fatty liver), and in patients with increased levels of fats such as cholesterol and triglyceride in the blood. When all these factors coincide, we say that the patient has metabolicsyndrome. Metabolic syndrome implies that a series of alterations occur in some of the proteins that regulate the formation and elimination of fats inside the liver cell, causing fat to accumulate inside small vacuoles or fat droplets. These gradually increase in size until they cause the rupture of the hepatic cell, and in affected patients it is reflected in frequently altered “liver transaminase” (enzymes found inside the hepatic cell and which pass into the blood, elevating their levels with the ruptures of the hepatocyte). Thisis often the only sign of the disease, asthepatient usually has no or very mild symptoms.

 The Risks

Most patients with non-alcoholic fatty liver have mild liver inflammation, and the likelihood of long-term severe liver lesions or complications in liver function is low. However,in 20% of cases, the damage caused to the liver is significant, and the patients may develop cirrhosis, thereby increasing the risk of liver failure or complications such as liver tumours.But this isn’t the only complication of fatty liver. It is knownthat the presence of significant hepatic steatosis is also an indirect cardiovascular risk,with these patients having a higher incidence of cardiac and vascular complications.The incidence of other tumours outside the liver is also higher among patients with the non-alcoholic fatty liver.

Diagnosis

Diagnosing non-alcoholic fatty liver in patients with the suspectedliver disease is a challenge. The study of these patients, at the first instance, has to rule out the existence of other coinciding liver pathologies,such as hepatitis or alcohol abuse, as well as those that could worsen the prognosis of the patients. It is also important to try to identify those cases when a patient has a fatty liver with more pronounced inflammation and is, therefore, more likely to have complications in the future. Detection of such cases allows special surveillance for this high-risk subgroup, as well as the implementation of a therapeutic plan based on the combination of a diet and physical exercise to reduce the overweight and insulin resistance usually present in diagnosed patients. Besides, the use of some drugsin certain circumstances can also help control and improve the disease and its associated comorbidities.

Back pain at work and school

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on06-09-2018

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Some pains arevery familiar to all of us. One of them is back pain. This ailment is, for various reasons, one of the most frequent reasons for medical consultations both in adults and children, but why? As we approach back-to-schooland back-to-work time of the year, what recommendations can we use to prevent and alleviate these annoying pains?

Dr Antonio Narvaez, Head of the Traumatology Department at the Vithas Xanit International Hospital in Benalmádena tells us why our back hurts, and also offers us some advice on how to address this problem.

Back pain is very common among the general population and is largely due to bad postural habits in a spine with poorly exercised back musculature.

Back pain problems can vary according to patient’s age – in children they may be due to problems of scoliosis or small fractures in some parts of the vertebrae.In middle age patients, the back problems are mainly due to pathological intervertebral discsthat can trigger herniated discs and in elderly patients,the back pain is usually due toproblems in disc dehydration, resulting in nerve compressions and instabilities in the spine. Whetherwe are dealing with cervical or lumbar pain, usually in almost all cases the origin of the pain is in disc pathologies which are a commondenominator.

Recommendations for back-to-school… and work

Oftenwhen children complain of back pain at school, the main recommendation is to maintain good postures while studying, avoid carrying heavy loads on the back and do physical exercise.

For adults with back problems at work, the recommendations are similar, fundamentally postural changes and building muscle strength and flexibility.

We might avoid back pain or prevent its recurrence by improving our physical condition and learning and practisingproper body mechanics.

If we analyse the way we should hold our body, the correctposture is sitting with the back upright, avoiding flexure.We should choose a seat with good lower back support, armrests and a swivel base.

We must avoid, whenever possible, carrying the heavy load on our back, movements that twist or strainour back and avoid heavy lifting. Our spinal column is not designed to carry heavy loads. We should be using alternative weight-bearing systems so that our vertebrae and discs do not have to sufferthe weight, thus helping us maintain the health of our back.

Well-practisedsportsactivity can also help us to prevent back pain, because the strengthenmusculature stabilisesthe spine. However, it is important that we carry out the physical activity in a controlled way and whenever possible to be monitored by a good instructor, and to avoid exercises with heavy weights without being supervised.

We cantake measures to prevent or relieve most back pain episodes simply by following the recommendations given by the specialists in this field. However, in the case of severe pain, or development of further complications and symptoms, we should seek medicalhelp.

Vitamin D: A source of health for our body (Part II)

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on09-07-2018

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There is a common belief that there is only one type of Vitamin D. In fact, there are several. Of these, those that interest us for our health are D2 and D3.

Vitamin D2 is a prohormone that is mainly found in fungi as of ergosterol molecules in combination with ultraviolet radiation from the sun. Some plants contaminated with fungi are capable of having Vitamin D2 in their composition.

On the other hand, Vitamin D3 is generated by plants in their normal state and by animal cholesterol molecules together with the interaction of ultraviolet light.

 

Vitamin D3 or D2: which one is better?

Until recently it was believed that both forms of Vitamin D were similar. However, clinical trials have shown that D3 is much more beneficial.

Clinical studies have revealed that Vitamin D3 is much more effective than D2. People who take Vitamin D3 get twice the level of Vitamin D in their body, compared to those who take Vitamin D2.

 

Fortification of food with Vitamin D

In recent years, many retailers in the food industry have enriched their products with Vitamin D2 in the belief that it meets the daily needs of consumers. However, clinical studies have shown that Vitamin D3 is much more effective than Vitamin D2.

People who eat foods that contain Vitamin D3, such as fish, eggs, or Vitamin D3 supplements, increase their Vitamin D levels much more than people who eat foods that contain Vitamin D2, such as bread or milk enriched with Vitamin D2 or dietary supplements of Vitamin D2.

 

Curiosities of Vitamin D

It has been proventhat 90% of Vitamin D is produced directly in the body using UVB radiation from the sun and that only the remaining 10% is acquiredthrough diet.

The farther we live from the equator, the darker skin we have, the more overweight we are and the less exposedwe are to the sun, in those cases we should be taking more Vitamin D supplements, either through food or as a dietary supplement, to achieve healthy blood levels of this vitamin.

Walking for 20 minutes a day in winter may be well-intentioned advice, but it is not enough to synthesise the amount of Vitamin D needed for our body.

Vitamin D has an antimicrobial effect by enhancing the immune system as well as anti-inflammatory properties. Thus, it plays a decisive role in preventing acute or chronic inflammation and accelerating the healing process.

Vitamin D is used to prevent Alzheimer’s, as it facilitates communication between nerve cells and therefore, protects them from long-term death.

Russian and German athletes have used the benefits of the sun to improve physical performance for the past 30-40 years. They knew that Vitamin D promotes muscle efficiency and endurance, and, therefore, helps improve sports performance.

Clinical studies show that Vitamin D is essential for maintaining optimal conditions of our brain and state of mind and that its deficiency can lead to depression.

With age, the body gradually loses the ability to synthesise Vitamin D through sunlight. At the same time, the age increases the body’s need for Vitamin D.

Antidepressants, anticoagulants, corticosteroids, and medications to treat peptic ulcer and epilepsy may inhibit the absorption of the Vitamin D we take through our diet. Also, people with heavy alcohol consumption may be at increased risk of Vitamin D deficiency. They are advisedto take Vitamin D as a supplement.

Vegans, in particular, are at higher risk of Vitamin D deficiency, as this vitamin is usually contained mainly in foods of animal origin. However, mushrooms and avocados also contain Vitamin D2 and a precursor of Vitamin D3.

Sunscreens prevent the synthesis of Vitamin D. For that reason, to get our body to generate Vitamin D, we should walk for 10-20 minutes without sun protection and then apply the sunscreen.

However, the sun exposure poses a dilemma, while it may be useful for producing Vitamin D, which protects us against certain types of cancer, osteoporosis, Alzheimer’s and other diseases, it is worth considering whether it can cause skin cancer.

Vitamin D: A source of health for our body (Part I)

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on03-07-2018

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We have always talked about Vitamin D as something essential to strengthen our bones. However, it is now knownthat further to keeping our bones and teeth healthy, it intervenes in the functioning of almost every organ and tissue in our body. More specifically, it is essential for the metabolic process of the intestine, brain, heart, pancreas, skin and lymphocytes.

That is why a deficit of Vitamin D affects our whole body, and it is essential to re-establish its normal, required levels as soon as possible.

 

Vitamin D protects our health and prevents us from possible illnesses

Maintaining proper levels of Vitamin D in our body is imperative. Because, apart from its benefits for our bones, Vitamin D prevents the onset of a large number of diseases:

  • Autoimmune diseases
  • Common cold
  • Bone diseases (including rickets)
  • Osteoporosis
  • Bone and back pain
  • Depression
  • Diabetes
  • Cardiovascular diseases
  • Hypertension
  • Chronic inflammation
  • Disorders of the immune system
  • Muscle weakness
  • Psoriasis
  • Rheumatoid arthritis
  • Neurological diseases
  • Alzheimer
  • PMS
  • Cancer

We cannot say that these diseases are caused solely by a deficiency of Vitamin D. However, researchers believe that the lack of Vitamin D is a decisive factor contributing to the development of these pathologies and that, on the other hand, we can minimise their risks by maintainingadequate levels of Vitamin D.

 

Threedifferent ways to get Vitamin D

Our body can obtain its daily needs of VitaminD in 3 different ways:

  • Daily sun exposure can provide an indirect source of vitamin D. Although sunlight itself does not contain Vitamin D, it promotes the synthesis of this vitamin in the body. Healthy exposure to the sun’s UVB rays is the most natural and practical way to achieve the right levels.
  • By eating natural foods that contain this vitamin: oily fish, butter, milk, egg yolk, cheese…
  • There arevitamin D supplementsthat become a good option for people with vitamin D deficiency. They are practical and very effective.

Symptoms of a Vitamin D deficiency

Many symptoms makeus suspect that a patient has a deficit of Vitamin D:

  • Rickets in children
  • Osteomalacia (softening of the bones)
  • Osteoporosis(fragile bones)
  • Musculoskeletalpain
  • Susceptibility to allergies
  • Respiratory tract infections
  • Organic pain

 

These symptoms improve and even disappear when the level of Vitamin D in the body normalises.

Infectious meningitis in children

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on24-05-2018

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The paediatric meningitis is, without a doubt, one of the diseases that cause the mostconcern for parents. However, we should emphasise that, despite the potential severity of the disease, it is rare in Spain, with the majority of cases occurring in children under five years of age, especially children under one year of age and adults over 65. This post aims to give parents a little insight into the symptoms of bacterial meningitis and how to treat them. First of all, let us find out a bit more about this disease.

 

What is Infectious Meningitis?

The meninges are membranes that cover and protect the Central Nervous System (brain, cerebellum and spinal cord), further to performing other functions. Between the meninges, there is the cerebrospinal fluid, which surrounds the Central Nervous System and also contributes to its functions.

When a germpenetrates these membranes and reaches the Central Nervous System,inflammation of the meninges (“meningitis”)occurs as a result of both the pathogenic activity of the germ and the body’s defensive response to the invasion. Some patients may also have certain risk factorsthat make them especially prone to some types of meningitis.

In addition to infectious meningitis, which is the most common type, other diseases can cause meningeal inflammation by abnormal activation of the immune system in the absence of infection (autoimmune meningitis).

 

Types of meningitis depending on the causing germ

Viral meningitis:Produced by a multitude of different viruses. It is the most frequent type of meningeal inflammation.

Bacterial meningitis:Caused by different bacteria. It is the most severe type of meningitis. The most common bacteria in our environment today are meningococcus and pneumococcus. In newborns, the most common are germs related to the birth canal.

Tuberculous meningitis: Caused by the bacteria that causes tuberculosis. It is also a severe type of inflammation, more frequent in immunocompromised patients. However, nowadaysit is very rear to see this type of meningitis in our environment.

 

Symptoms of Meningitis

Symptoms, as in almost any infection in Paediatrics, depend on the age of the patient. In general,the younger the child, the more non-specific are the symptoms, although fever is present in virtually all cases.

Innewborns and small children, irritability or drowsiness may also occur.

In older children, headache, vomiting, stiff neck, or sleep tendency are more common.

In all cases,seizures or other signs of neurological involvement may occur. The range of possibilities is very wide.

 

In any case, it is essential to bear in mind that these symptoms can be non-specific and could be a part any other banal infectious process,so when in doubt, it is crucial to assess the patient by a paediatrician.

 

How we diagnose Meningitis

First, thecomplete medical historyis analysed, and a detailed physical examinationis performed to establish the diagnosis of suspected acute meningitis.

If there is any suspicion, a blood testis usually requested, which in many cases can help the diagnosis and differentiate one type of meningitis from another.

However, the only test that can confirm or rule out the diagnosis of meningitis and identify the germ causing the infection is the lumbar puncture.

Besides,imaging tests, such as cranial ultrasound or computed tomography (CT), are sometimes performed at the discretion of the paediatrician.

 

Lumbar puncture as a definitive test

It is the only test that can confirm or rule out the diagnosis of meningitis and identify the germ causing the infection, so it should always be performedif meningitis is suspected and in the absence of any of its few contraindications.

Cerebrospinal fluid sampling is a technique in which a sample is removedthrough a puncture in the lower back. It is usually performed under topical anaesthesia in the form of cream over the puncture site, although depending on the age and the specific case, it can also be performed under sedation with systemic mediation, generally, but not exclusively, intravenously.

With this technique, complications are infrequent and almost always local (pain after the puncture, local bleeding, etc.). In children, pain or stiffness in the back after the puncture is much less common than in adults. In some children, especially newborns and small infants (because of their small size) the technique may be somewhat more complicated and more than one attempt may be needed to obtain a valid sample (it may even be that no sample is obtainedat all).

 

Treatments for infectious meningitis

Viral meningitisrequires almost no specific treatment at all.It heals on its own after a few days, so the only treatment is theusual analgesicsto control possible symptoms (such as a headache, malaise). Many of the patients affected by viral meningitis do not even need hospital admission and can be treatedat home. A notable exceptionis the case of infection with the herpes virus(herpetic meningoencephalitis), which is a severe condition thatrequires hospital admission,often in paediatric ICU, and prolonged intravenous antiviral treatment.

In all cases, bacterial meningitisrequires hospital admission and intravenous antibiotic treatment, sometimes with more than one antibiotic until the causal germ is identified. Also, other treatments,such as corticosteroids, anti-epileptics or intravenous fluids, may be necessary.

 

Infectious Meningitis Prognosis

Viral meningitis heals itself, and the possibility of complications or sequelae is extraordinarily rare, except in the case of herpetic meningoencephalitis, which is associatedwith a high percentage of neurological sequelae and mortality, even with adequate treatment.

Bacterial Meningitishas a mortality of practically 100% of the cases if proper antibiotic therapy is not started, although with a correct treatment patient clinical progress is usually good. However, even in this case, it can also be associated with neurological sequelae and mortality.

Still, the actual prognosis depends on many factors(age of the patient, progress period, the presence of other risk factors, causal germ).

 

Can infectious meningitis be prevented?

Viral meningitis cannot be prevented.The viruses that cause it are multiple, and of constant circulation between humans, so it is impossible to avoid contact with them. The exception is herpetic meningoencephalitis,in which case there are some measures to avoid infection in the birth canal in newborns, although there is no real prevention option at a later age.

Most bacterial meningitis can be preventedby using vaccines.Severe meningitis caused by some bacteria very common a few years ago, such as those produced byHaemophilus influenza type B or meningococcus C, have decreased drastically today (they have almost disappeared in the case of Haemophilus) thanks to the vaccination of the entire population against these germs included in the vaccination calendar financed by the Public Health System. Another bacterium that causes many cases of meningitis is pneumococcus, whose vaccine (Prevenar 13®) has also recently been includedin vaccination programs throughout Spain.

Finally, vaccines against the rest of the meningococcal serogroups are also available on the private market.In this respect, it is worth noting:

  • Vaccinesagainst meningococcus B: Bexsero®and Trumenba®. The first type of vaccine can be administeredto infants sixweeks old and the second, to children from 10 years onward. They are recommendedfor all children, especially those under the age of 5, when the disease outbreak is most common.
  • ACWY meningococcalvaccines: Nimenrix®and Menveo®. Recommended for teenagers who are going to travel to risk areas or who have some factors that make them especially susceptible to the disease. The administration of this particular vaccine can also be assessed in other adolescents to increase the degree of individual protection.

In some specific cases, such as in patients with risk factors, those under current outbreaks of the disease or laboratory personnel, these vaccines may be financed by Social Security.

In addition to vaccines, preventive antibiotic treatmentis recommendedwhen in close contact with confirmed cases of bacterial meningitis, which, in the event of school outbreaks, can be extended to all school staff and students.

The importance of keeping our hands clean

Posted by Xanit Internacional Xanit Internacional | Posted in Xanit salud | Posted on04-05-2018

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Saturday 5th of May celebrates World Hand Hygiene Day. In that honour, we have asked some related questions at Vithas Xanit International Hospital to help us become more aware of the importance of keeping the hygiene of our hands, and this is what we found out:

  • 1- Which hygienic method is better, the liquid disinfectants we see in hospitals or washing with soap and water?

Liquid alcohol-based disinfectants, such as those we see in the hospital, as long as the hands are not visibly dirty. Liquid disinfectants are faster, more effective method and better tolerated by hands.

  • 2- When we wash with soap and water, what is better, hot or cold water?

It is better to wash our hands with cold water as hot water causes greater skin irritation.

  • 3- In general, where can we find the most microbes in our houses?

On the remote controls, computer keyboards and smartphone screens. They can accumulate up to 450 bacteria per key.

Also, handles, doorknobs and switches usually carry the most germs in our houses. The bacteria and dirt carried on our handsaretransferred onto to these surfaces simply by touching them, and bacteria remainuntil we disinfect them.

Then, kitchen sponges and towelsare also objects that accumulate large amounts of bacteria.

  • 4- Does having well-cared hands influence whether we are more or less prone to infections?

Yes, skin irritation of the hands and possible injuries caused by soaps or detergents should be avoided and combated with the use of creams.

  • 5- How should our hand hygiene be when we have pets?

We should always wash our hands after touching a pet, its bed, or any object, such as food or food containers, that comes in contact with the pet.

Always wash hands before preparing or serving food and after touching a pet.

  • 6- With the alarm that there were E Coli infections at the time, what is the correct way to handle fruits and vegetables?

Before handling fruits and vegetables, it is important to wash our hands, especially after using the toilet.

Fruits and vegetables should be washed with running water, especially if they are to be eaten raw.

It is also important to avoid cross-contamination of food by cleaning and disinfecting surfaces that come into contact with food, such as cutting boards, kitchen worktops or refrigerator shelves.

  • 7- In the case of eggs and salmonella, what type of measure should we take?

Wash hands and objects that come in contact with raw eggs (dishes, utensils, cutting boards).

We should cook eggs until the egg white and yolk are firm. Dishes made with eggs should be cookedat an internal temperature of 71°C or higher.

Keep eggs refrigerated at 4°C or cooler at all times.

Eat or refrigerate foods containing eggs after cooking. Do not keep eggs, or foods made with eggs, at room temperature for more than 2 hours, or 1 hour if the temperature is elevated, for example in summer.

Throwing away dirty or broken eggs

We recommend that foods containing raw or undercooked eggs, such as Hollandaise sauce or mayonnaise, be made only with pasteurised eggs.

CDC Recommendations: Centres for Disease Control and Prevention

  • 8- What practical measures, related to the hygiene of our hands, should we take when we go to a restaurant or bar?

Wash hands before starting to eat and always after going to the bathroom.

  • 9- It seems that certain elements or circumstances related to our hands can increase the chances of having a sanitary problem. What’s worse in these cases?
  1. Wearing jewellery
  2. Skin lesions
  3. False nails

They can all have a negative influence when it comes to adequate hand hygiene.

  • 10- Are the railings of standard staircases and escalators hygienically dangerous?

Handrails on escalators and staircases are a point where germs can collect, no more dangerous than doorknobs or switches. If we do proper hand hygiene, they do not pose any danger.

  • 11 – What specific hand hygiene measures do you have in a hospital when you come into contact with a patient?

Hand hygiene should always be carried out before and after contact with the patient according to WHO guidelines.

Sport and sudden death

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart, Xanit salud | Posted on26-04-2018

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Exercise is one of the most potent medicines out there, but unfortunately, in very few instances, people can experience a very catastrophic event while exercising: sudden death. Many are the cases of young boys and girls, top sportsman, highly prepared athletes, who become victims of sudden cardiac death while practising sport or undergoing a high or moderate physical exertion. However,what does sudden cardiac death implies? Why does it happen and how can we avoid it?

Dr Juan Jose Gomez Doblas, a cardiologistat Vithas Xanit International Hospital,explains in this post what sudden death is.

By sudden death we mean death that occurs unexpectedly, naturally, non-traumatically, non-violently, and in a short period. It is consideredto be related to a sports activity when the symptoms appear during the exercise or one-hourpost-exercise.

There are also cases of Sudden Infant Death Syndrome, but this should be considered as a separate condition because it includes different causes, not always well identified and not entirely of cardiological origin.

Sudden death is not more common in athletes,but it does have a high media impact when it occurs among athletes who have a healthy lifestyleand get regular exercise. However, exercise acts as a trigger in some cardiac pathologies which in result may induce sudden death.

In some types of cardiopathy, there may be symptomssuch as chest pain or asphyxia on light physical exertion, or repeated syncopes.

The prevention of sudden deathassociated with the sportwe can base on two fundamental pillars:

1) Medical examinationbefore engaging in sports activity.

(2) The establishmentof the necessary mechanisms for appropriate cardiopulmonary resuscitation and defibrillation.

With regard towhen to undergo a medical check-up, we recommend it to those people who are over 40 years of age and who are going to engagein a particular sporting activity. Also, a full medical check-up is recommendedfor people under 40 looking to improve their exercising performance, people who present any of the related symptoms or those with a family history of sudden death.

Only in a small percentage of patients, sudden death can be hereditary.

The familyhistory of heart disease can also be related to sudden death syndrome, as well as in the caseof patients with acquired advanced cardiopathy.

We should not confuse a heart attack with sudden death, even though the most common cause of sudden death after the of age 40 is precisely heart attack. What happens is, that after an acute heart attack, an arrhythmia may be triggered, leading to sudden death.

Ideally we should all have adequate training in basic Cardiopulmonary Resuscitation so we could help those who might be suffering from the condition.It is something that we should teach the majority of the population, even at schools.

Childhood cough or asthma

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on28-02-2018

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Asthma is a chronic condition of the respiratory tract which is characterised by a group of symptoms and a series of positive diagnostic tests. Generally these tests cannot be performed correctly until the age of 6 or 7, therefore the term “recurrent wheeze” is recommended when talking about children younger than this, or a nitric oxide test can be performed from the age of 4 if the patient is able to cooperate.

Today Dr Carlos Hermosos Torregrosa, Paediatric Respiratory Physician at Vithas Xanit International Hospital, answers some of our questions relating to this condition, which tends to be more complicated during the colder months.

.              What respiratory difficulties occur with asthma?

Clinically a cough and shortness of breath are typical in the asthma process. It is often episodic, and in some cases it is shown to be related to a lung allergen, always occurring at the same time of year.

When correctly controlled in children, it will appear on rare occasions throughout the year (once or twice), manifesting as a cough when exercising and at rest, usually becoming worse at night.

.              What signs should parents look out for?

A cough is the main sign that parents should look out for to predict the onset of an asthma attack. Other signs such as indrawing of the abdomen (subcostal retraction) or increased breathing rate appear when the attack is already quite advanced.

.         How is asthma diagnosed?

One of the most common and well-known tests used in the diagnosis of asthma, also used when assessing the level of control, is spirometry with the bronchodilator reversibility test. This helps to determine lung function, however sometimes use of this technique alone is not sufficient to diagnose the condition. In the last few years there has been a rise in use of the fractional exhaled nitric oxide (FeNO) test. This has the advantage that it can be performed at an earlier age than spirometry, from the age of 4 in selected patients. This test determines the nitric oxide exhaled at a proximal level (in the bronchi), as well as at a distal or alveolar level.

  • How is asthma treated? Which treatments are most effective?

There are many asthma treatments, however it is important to differentiate between the two main types: treatments focused on an acute attack, and maintenance treatments which are prescribed to correctly control the asthma and minimise the number of attacks.

The most effective treatments for asthma attacks, approved in national and international asthma guidelines, are INHALED, never oral, short acting β2-adrenergic bronchodilators: salbutamol and terbutaline.

There are also studies which show that adding corticosteroids, such as budesonide, to inhaled β2-adrenergic bronchodilators, increases their effectiveness by reducing the bronchial inflammatory component which always accompanies an acute asthma attack. When an attack is serious, these inhaled treatments are accompanied by oral corticosteroids.

With regard to maintenance treatment, there are also many options such as leukotriene receptor antagonists (montelukast), inhaled corticosteroids (budesonide/fluticasone), or combined inhaled corticosteroids and long-acting β2-adrenergic bronchodilators (formoterol/budesonide, salmeterol/fluticasone) which are prescribed depending on the patient’s clinical history.

Additionally there are some vaccines which are particularly recommended for asthmatic patients due to their higher risk of suffering from serious infections and increased risk of complications due to certain pathogens. With this in mind, it is important that providing there are no contraindications, these patients, and those they live with, have yearly flu vaccinations, preferably with a quadrivalent vaccine. As well as the flu, it is essential to vaccinate correctly against pneumococcus.

  • Can asthma be prevented?

No. If an individual is genetically predisposed to developing asthma, currently there is no way of preventing it.

However, it is possible to prevent exacerbations of asthma and improve control of the disease.  This is achieved through individual, specialist outpatient monitoring and control, where the necessary tests and required maintenance treatment is prescribed for each child, with the aim of achieving better control of the disease with as little medication possible.

The tests required for diagnosis of the condition are the respiratory function tests already discussed, using spirometry with the bronchodilator reversibility test, and FeNO tests which should be performed in all children when an allergic component is suspected.

Furthermore, both spirometry and FeNO are used for monitoring of the condition, FeNO has the advantage that it can be performed in younger children (from age 4) predicting attacks in children who are apparently well controlled.

  • Should a child with asthma change their lifestyle? (Sports, games.)

A child with asthma can lead a normal life. There are many examples of elite athletes who take part in their sport without any limitations due to their asthma.

  • Are children of parents with allergies more likely to suffer from asthma?

It is a subject still under discussion today, but it appears that children with a history of a first degree relative with asthma, or with a strong allergic component, are more likely to suffer from asthma in the future.

A detailed clinical history during a specialist consultation gives the asthma predictive index (API), which is a very useful tool in determining the type of treatment and monitoring which the patient is going to require.

What is clear today is that a child under the age of 3 who starts with repeated bronchial episodes, and who has a family history of asthma, must be observed and strictly monitored until the age that the necessary tests to diagnose asthma can be performed.

Dr. Carlos Hermoso Torregrosa (Paediatric Respiratory Physician),