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The constant fight against Alzheimers

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 30-12-2015

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Today Dr. Víctor Campos, Head of the Neurosciences Department at Vithas Xanit International Hospital, and an expert in this particular pathology.

What are the latest advancements in the fight against Alzheimers? Is it possible to preven this disease?

Research indicates that it could be possible to eliminate the early accumulation of abnormal proteins in the brain, which are responsable for the development of this pathology. However, as yet,  research has not found a way of preventing the pathology. If these proteins are eliminated the symptoms could be improved, or completely stopped, which would be an enormous advancement in the management of these types of problems.

In cases where genetics play a part in the development of the disease, genetic engineering could drastically modify the development of Alzheimers. However at this stage evidence of this is only experimental.

When dealing with Alzhiemers disease, how do the Neurosciences Department help patients?

The hospital coordinates diseases related to the nervous system from a multidisciplinary point of view incorporating the different departments implicated in the treatment plan.  Each unit is extremely varied and complex from a medical point of view, and incorporates different specialities. These include Neurology, psychiatry, neurophysiology, psycology, and logopedy.

The work carried out by this group of specialists is particularly important when confronted with diseases such as Alzheimers, which can effect various aspects of the human mind.  It is important not to forget the environment surrounding the patients, as this is usually implicated, and also requires care and expert advice.

A team such as this is able to carry out varied diagnostic tests: this type of investigation is made even more complex due to the fact that the general public have more knowledge about memory problems, and therefore worry more. It goes without saying that not all memory associated problems are related to a neurodegenerative disease such as this. However patients seeking advice are unsure of this, and may fear the worst case scenario.

How does the team fight against Alzheimers? 

We try to obtain a diagnosis as early as possible, and give special attention to ‘’presenile’’ cases, which are those with the most repercussions on the patient and their environment. Constant advancements in neuroimaging techniques (RNM) and funcional imaging (PET) enable us to study the proteins and the substances contained within the cerebrospinal fluid.

It is also vital to carry out a neuropsycological evaluation on the patient. This procedure is extremely useful and precise in detecting problems early on, and is an important process in order to rule out other pathologies (whose progression and treatment are very different). This evaluation requires highly trained personnel (psycologists/neuropsycologists) who have both diagnostic and cognitive rehabilitation experience.

Once a diagnosis has been established, pharmacological treatments, prescribed and controlled by the neurologist, help to delay the onset of sysmptoms and to better control them. Furthermore the strategies in place for ongoing cognitive rehabilitation are also beneficial.

There can also frequently be behavioual symptoms. Therefore patients need to have a neuropsychiatric evaluation, in order for the psychiatric team to establish strategies to deal with and treat these manifestations. This service is now available within the Neurosciences Department at the hospital.

What advise is given to the families of patients with Alzheimers?                                           

The first is that they obtain as much correct information about the disease as possible. They need to understand the evolution of the illness and the symptoms that will occur with the progression of the disease, as well as the strategies in place to handle the main problems.

Secondly families should communicate with professionals throughout each phase of the disease, to discuss pharmacological and non-pharmacological issues. When families are obsessiviely caring for the patient this can result in illness and symptoms for the carer, which can further complicate the family environment.

Finally, patients and their families can contact special Alzheimers support groups. These can be useful, and allow families in similar situations to compare cases, and to give them some respite.

What shouldn’t we forget about Alzheimers?  

That the disease has become one of the most important social care issues in the western world, and that if managed correctly the illness the side effects can be controlled. One of the main problems is ignorance about the disease.

Dr. Víctor Campos

Head of the Neurosciences Unit at  Vithas Xanit

 

Information about COPD

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 30-12-2015

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Día EPOC

 

COPD is a pathology which is characterised by a cronic limitation of the flow of air in the lungs, and is mainly caused by tobacco smoke. Dr. Gustavo A De Luiz, Head of the Pneumology Department gives us key information about this disease.

What is COPD?

Cronic Obstructive Pulmonary Disease (COPD) is a cronic limitation of air flow. The condition is normally not reversible, and is caused principally by tobacco smoke. One of the main problems with this pathology is that it often remains undiagnosed, and provokes different symptoms which limit the quality of life of the patient. Furthermore it can be a complication of other pathologies such as diabetes, cardiac pathologies, renal insufficiency, etc.

COPD is prevalent in some 10% of the 40 – 80 year old population in Spain. Although it occurs more frequently in men, this pathology is also increasing amongst the female population. This is particularly due to the increase in the number of women smoking. Furthermore, an ageing population has also provoked an increase in the number of people suffering from this disease in recent years.

What are the causes?

The main cause of this illness is tobacco. Some 90% of those cases diagnosed are as a result of smoking, although this is not the only cause. Breathing in certain smoke, or genetic factors can be a factor, or indeed a cause of COPD. Passive smokers can also carry certain risks, as the smoke that they inhale produces a combustion, and is not filtered. Therefore it contains a higher percentage of harmful substances.

What are the symptoms?

A cough is the most common initial symptom, and a drowning sensation the most important. In the initial phases of the disease the patient may not have related symptoms. However, as the disease progresses the cough will worsen considerably, there will be more coughing up of mucas, and an increased sensation of drowning.

With the passing of time the drowning sensation or dizziness will progressively worsen until it affects the quality of life of the patient. The dizziness is the symptom which will most affect the patients daily life.

How is the condition detected and diagnosed?

Some 40% of people with possible symptoms do not consult their doctor, thus making it extremely difficult to diagnose the condition and prescribe the correct treatment. The symptoms, such as the cough, can be put down to smoking, and therefore many patients do not visit the doctor until they begin to feel dizzy, and notice a deterioration in their quality of life.

A diagnosis of COPD can be made fundamentally by carrying out a forced espiratory volumen test, which shows up the non-reversible cronic obtruction of air flow which defines this disease.  The forced espiratory volumen test involves a spirometry, and the patient inhaling the maximun quantity of air in the least possible time. This test can measure the flow of air, and the pulmonary volume, and the doctor then compares these measurements with those of a healthy patient of the same age, weight, and height.

Is there any treatment for this disease?

COPD is a disease which cannot be cured, but can be prevented and easily treated. The treatment depends on the actual state of the patient. The use of drugs, pulmonary rehabilitation, or surgery to reduce the volume can improve the symptoms, and the quality of life of the patient. Furthermore, there exist preventative measures, such as a vaccination, which has been shown to reduce the exacerbations of patients with COPD.

However, the best way of preventing this disease is to give up smoking. If the patient eliminates tobacco, they will also eliminate the main trigger of the pathology.

Advice for patients suffering from COPD:

  • Avoid tobacco and contaminated environments.
  • Follow a healthy diet, and try to partake in regular exercise to stay healthy.
  • Have adequate knowledge of the medication, and undersatand what can exacerbate the disease in order to keep it under control.
  • Attend periodic check-ups with a pneumologist.

Dr. Gustavo A De Luiz

Head of the Pneumology Department

 

Advise on how to prevent the flu

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 30-12-2015

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Once again this year Vithas Xanit is running their flu vaccinations campaign. For all of those persons who are worried about contracting the flu, and want to know how this injection works, we are talking today with Dr. Tamara Moreno García, an Internal Medicine Specialist at the hospital.

Who are those persons most at risk of contracting the flu?

Everyone is vunerable to infection, and can contract the flu virus. The problem lies in the severity of the infection in each patient, and therefore it is important to focus on elderly persons, premature newborns with complications, and the cronically ill who suffer more complications from the flu. For example, patients with cardiopathies,  cronic respiratory diseases, kidney problems, patients who are institutionalised, or those taking medication which reduces their defenses, such as patients with cancer on chemotherapy treatment.

Which is the best treatment?   

The flu is a viral infection, and therefore, has no specific treatment. In the case that a person contracts this virus, it is important to maintain a good level of hydration and nutrition, to avoid extreme changes in temperature, to stay at home if they have symptoms, and to take medication to alleviate the symptoms (antithermics, antitusígenes…).

In the majority of cases, this condition does not require hospital treatment, only in the case of those patients who develop complications and require oxygen therapy, rehydration or intravenous treatment to alliviate the symptoms.

Is the injection effective?       

Yes, it has been proven that the vaccination is effective, not only for preventing the infection, but also for minimising the symptoms and complications it a person still contracts the flu.

Should everyone be vaccinated? Which are the groups most at risk who should be vaccinated?

The vaccination is fundamentally aimed at protecting those persons who are at the most risk of developing complications if they contract the flu, and for those who can pass the virus to other persons who are at high risk of complications. It is also aimed at those who, due to their occupation, work alongside particular groups of people in the community. Here is a summary of the four highest risk groups:

  • Persons of 60 years of age or above, especially those living in closed institutions.
  • Persons of less than 60 years of age, at high risk of flu related complications (cardiac diseases, bronco-pulmonary conditions, kidney problems, cancer, pregnant women, patients with HIV, patients who have had transplants, diabetics, obese persons, or people on immune suppresant treatments).
  • Those persons who can pass the flu to others at high risk of complications (fundamentally carers and those working in the healthcare industry, or those living with newborn premature babies).
  • Other persons who are advised to have the vaccination are : those persons working in the emergency services (police, firemen etc).

Can can we avoid contracting the condition?

The flu virus is passed through the respiratory secretions of sick patients, or those incubating the virus. In order to prevent the condition it is important to:

– Cover the nose and the mouth with a tissue when coughing or sneezing, and them to dispose of the tissue.

– To wash your hands frequently, and to use disinfectant alcohol solution when in a hospital environment.

– Not to go too close to sick patients.

– Do not go to school or work when sick.

Can the flu be prevented by adequate nutrition?

Not specifically but adequate hydration and a healthy diet is important in order to maintain good health and to strenghten our immune system. This should be varied and balanced. It is important that we consume foods which contain vitamin C (cítrus fruits, kiwis and vegetables fundamentally).

 

Dr. Tamara Moreno García, a specialist in Internal Medicine at Vithas Xanit.

 

 

 

 

Discovering Breast Cancer

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 30-12-2015

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DM Cáncer

Today we would like to share key information about this disease, from the diagnosis and treatment through to the help that we can offer for patients, and the possiblilities of curing the illness. Dr. Antonio Rueda, an Oncologist at Vithas Xanit International Hospital goes into detail during the following interview:

How is Breast cancer diagnosed?

When a patient or a doctor suspects breast cancer, either during a physical examination or during a routine mammogram, specialists study the patient in detail to confirm the diagnosis. The images obtained give us an idea of the diagnosis. However in order to be completely certain it is necessary to take a biopsy.

The biopsy consists of taking a sample of tissue from the suspicious area. This is analysed under a microscope, in order to determine whether the sample has benign or malignant characteristics, to assess the type of tumour cells, how aggresive the cells are, and any other important observations which could influence the type of treatment required. This can be taken directly from the breast or by the use of a fine needle (PAAF) or a thicker needle (BAG) guided by an ultrasound, depending on the amount of tissue that needs to be extracted. On occasions it is necessary that the biopsy is carried out in the operating theatre.

If the biopsy confirms a diagnosis of breast cancer, other tests are carried out in order to evaluate the disease, and to see if it has spread to other organs. These include a thoracic x-ray, and an abdominal ultrasound or CT scan.

 

What are de symptoms of the disease?

Generally the main reason for women visiting a specialist is because they have found a lump in the breast, which is generally not painful. However other reasons for the patient to be concerned can be changes in the nipple or alterations in the skin of the breast.

If somebody has any of these symptoms, they should see a gynecologist or a surgeon in order that they can complete a full study if they consider it to be appropriate.

In the case of those women who are routinely having periodic mammograms in order to ensure early diagnosis, the disease should be diagnosed before any symptoms arise. In these cases the disease can be discovered in the early stages, and the probability of curing it is much higher.

 

What are the types and stages of the disease?

Types:

With the development of new techniques in the molecular study of biopsies there is now a more specific classification of the different types of breast cancer. These techniques have given way to a more precise classification of the pathology which demonstrates a reduced risk of recurrence of the disease, and enables us to select the most suitable treatment in each case. The molecular classification establishes four types of breast cancer: Luminal A, luminal B, HER 2 and basal like. The sub-type Luminal A is that with the best prognosis, and the basal like has the worst prognosis.

Stages:

As with other tumours, all of the sub-types of breast cancer are classified in stages according to the progression of the disease. A stage 1 breast tumour is breast cancer in the initial stage, and a stage 4 breast cancer indicates that the cancer has spread to other parts of the body.

The TNM classification system is based on the size of the tumour (T), and the extension of the cancer into the regional lymphatic glands (N), or to other parts of the body (M). Generally the stage of the cancer is unknown until the tumour has been removed and analysed to examine the state of the auxiliary glands.

Stage 0 or carcinoma “in situ”: there are only abnormal cells on the coating of the breast ducts. These are non-invasive, but if left untouched would evolve into an invasive carcinoma.

Stage I: A tumour of less than 2 cms which is contained within the breast.

Stage II: The tumour measures more than 2 cms but does not affect the skin or the pectoral muscles. Any tumour of less than 5 cm affecting the auxiliary glands on the same side.

Stage III or locally advanced: A tumour of more than 5cms which affects the auxiliary glands on the same side. A tumour which affects the skin of the breast. A tumour of any size which affects a supraclavicular gland or those glands situated behind the sternan.

StageIV: When metastisis exist in other organs. Those organs most frequently affected are: bones, lungs, liver and brain.

 

Which treatments are most recommended?

The treatment for breast cancer is different for each person, and is based on multiple factors. In order to give the best possible treatment there needs to be collaboration between surgeons, gynecologists, medical oncologists and radiotherapeutic oncologists.

Classically in the early stages of breast cancer the patient undergoes surgery and afterwards the systematic treatment is administered ( chemotherapyand/or hormone therapy), and radiotherapy (adjuvant treatment). However, it is possible to give the patient the systematic treatment first of all, and then to offer the patient the possibility of surgery and radiotherapy (neoadjuvant treatment). This strategy can enable specialists to perform surgery on more complicated patients whom it was not possible to opérate on prior to neoadjuvant treatment.

The systematic therapy can either be administered orally or intravenously in order that it is distributed to all of the organs. This type of therapy can be used when the disease is in the early stages (adjuvant or neoadjuvant), and also when the disease has spread or has become metastatic.

 

How can we help a patient psychologically when they are confronted with this disease, and particularly when they require surgery?

An important factor is that the patient has a positive attitude when confronting the disease in order to achieve a cure.

It is important to stress that there is an excellent prognosis for breast cancer, particularly in those cases which are diagnosed early. The surgeon should discuss the situation to the patient with emphathy and positivity, and explain that they are going to try and carry out the mosr suitable surgical treatment, in order to give the best possible chance of a cure with the least damage to the breast (this is usually surgery which is maintained within the breast).

In the case that the surgical treatment requires the removal of the breast (mastectomy), the surgeon should explain the possiblilities for reconstructive surgery later on.

It is important to point patients in the right direction, and to refer them to the relevant associations available. In this way patients can share their experiences with others in the same situation. In many cases, this can help to alleviate the social and work related effects of the disease which can occur.

If, in spite of adequate information, the patient is suffering psychologically, it is recommended that they visit a psychologist.

 

If you have a family history, what is the probability that you will develop breast cancer?

Those women with a family history of breast cancer have more risk of develop the disease, and particularly if a member of their immediate family has had it (mother, sister, or  daughter). However, in the worst case, this risk is only moderately higher than for other people.

Another case is that of hereditary breast cancer. Heriditary cancer indicates that the origin of the disease derives from a genetic mutation. It is estimated that between 5 – 10% of breast cancers are hereditary. Those families with women diagnosed with breast cancer before the age of 40, bilateral breast cancer, or more than one family member with breast cancer and/or ovarian cancer are those who are the most likely to carry a mutation of these genes.

 

What are the reccomendations once a patient has survived the disease?

1.- Return to normal life, and try not to focus on the disease. This is more difficult around the time of periodic check-ups.

2- Value the important things in life and enjoy them to the full.

3- Adopt a healthy lifestyle which will help to reduce the risk of a recuurence of the disease or a second breast tumour. It is recommended that women maintain a healthy weight with a good diet, and that they do not consume excessive fats or alcohol, and that they partake in moderate excercise (at least 3 times a week).

4 – Consider joining a self help group with other patients.

Dr. Antonio Rueda

Oncologist at Vithas  Xanit International Hospital