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Back to school: smoothing the transition

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 20-09-2016



Going back to school after the holidays is a big change in daily routine, making it a good time to introduce healthy habits into children’s lives. To make the transition easier for children and parents, it is worth keeping a few thing in mind:


A good night’s sleep is the first step. School age children need to sleep for between 9 and 11 hours a day. A good sleep pattern supports learning and helps recuperation and growth.

It’s a good idea for children to start going to bed early a few days before returning to school to help them adapt to their new timetable.


School bags

Backpacks should be lightweight, have two shoulder straps and not be too heavy. The recommendation is that they should not weigh more than 10 to 15 % of the child’s weight.


Getting to and from school

Walking or cycling is recommended when distances allow, encouraging physical activity. Please see the following advice for children when using different methods of transport:

On the school bus.

  • Wait until the bus stops before approaching it from the kerb.
  • Do not walk about inside the bus.
  • Before crossing the street check that no cars are coming.
  • Make sure you stay in sight of the bus driver.


In the car:

  • All passengers should use the appropriate seat belts/booster seats.


By bicycle:

  • Always use a helmet for cycling, however long or short the journey maybe.
  • Know the rules of the road and follow them.



  • Make sure children use a safe route and know the rules for staying safe.
  • Ensure a child is old enough to be safe travelling without an adult before going to school alone.



Breakfast is the most important meal of the day. As well as improving performance in school, it helps children to maintain an appropriate weight.  The ideal breakfast for a child consists of between 20 and 35% of their daily energy intake. It should include milk or dairy produce, cereals and fresh fruit or natural fruit juice to provide energy, protein and vitamins. Paediatricians recommend that the family should eat breakfast together in an unhurried, stress free environment. With this in mind it is a good idea to wake children early, leaving them plenty of time to be able to finish their breakfast calmly.

It is also useful for parents to make a note of school lunch menus when preparing dinner, making sure that children have a varied, balanced diet which includes fruit and vegetables every day. It is better to opt for seasonal fruit and vegetables, they taste better, they help to vary the menu and they encourage children to eat different types of foods.  Reduction of salt consumption is also important, up to 3 grams a day for those under the age of 7, 4 g a day for those aged between 7 and 10 and up to 5 g a day for adults.

Prevention: schools and spread of infection

Enclosed spaces, such as classrooms, encourage the spread of those illnesses transmitted by contact or breathing (coughing, sneezing, etc.) as well as common infections such as gastroenteritis, colds and conjunctivitis. Other infections such as whooping cough, measles or meningitis can also be spread. With this in mind it is a good time to review children’s vaccinations and update them if necessary, avoiding preventable diseases through vaccination. For those conditions where a vaccine does not exist, hygiene measures such as frequent hand washing, adequate ventilation of enclosed spaces and cleaning of materials used by everyone in the classroom, are important.

All parents of children with chronic conditions such as asthma, diabetes, coeliac disease etc, and of those children who suffer from allergies or other health problems which may affect them, should inform the teachers or school head of the problem and any measures which may need to be taken.


After school


On arriving home from school, children need to be supervised. A responsible adult should be available when they return home.

Many children take part in after school activities. It is important that activities are appropriate for the age group, do not prevent children from having free time or time to rest, and that they do not become a daily chore.

Exercise: At least one sporting activity outside school

As school age children ought to do at least one hour of moderate-intense physical exercise a day, when planning timetables and extracurricular activities it is advisable that at least one of them is related to sport. This also establishes a routine which helps to prevent the development of obesity as well as improving school performance and the child’s state of mind.

We should remember that when children take part in sports, they need to have the correct clothing and footwear, as well as the appropriate safety equipment.


Dr Marta García Ramírez

Paediatric Department Vithas Xanit International Hospital

Lung Cancer – What is it and what are its effects?

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER | Posted on 15-09-2016


Dr. Cristina Quero, lung cancer specialist, is here today to talk to us about this condition, one of the most commonly occurring cancers in the Spanish population.


What is lung cancer?

Lung cancer is a malignant tumour disease in which normal cells change into tumour cells, these cells lose their normal function and grow uncontrollably.


What are the main symptoms?

Occasionally lung cancer does not produce any symptoms and is often a casual finding on a chest X-ray requested for other reasons.

As the tumour grows symptoms start to appear, the most frequent ones being: tiredness, cough, weight loss, difficulty in breathing (dyspnoea) or the presence of blood stained sputum (haemoptysis).

When the tumour spreads and metastases appear they in turn can produce symptoms related to the affected organ (bones, liver, brain, adrenal glands).


What factors cause it to occur?

The main known risk factor in the development of lung cancer is exposure to tobacco smoke, the majority of lung cancers occur in people who smoke.

We also know that asbestos (a mineral occurring in many types of rock and used in insulation) is another risk factor in the development of lung cancer. Its fibres can irritate the lungs when inhaled by workers who are exposed to it (naval shipyard workers, miners).


Which are the most common types of lung cancer?

There are 2 main types of lung cancer: small cell and non-small cell, being named in accordance with the cell from which they originate.

It is important to differentiate between the two types as they are treated in very different ways.


What investigations are required to detect lung cancer?

If a patient is suspected of having lung cancer a series of tests will be performed to help us to confirm our suspicions, and to know the extent of the disease so that the most appropriate treatment can be given.

The first diagnostic test usually performed is a chest X-ray followed by a CT scan. These help to confirm the location and spread of the disease.

For confirmation of the diagnosis, and to know the subtype of the lung cancer, a biopsy is essential, this is generally performed via bronchoscopy. This test involves introducing a tube through the mouth into the bronchi to take a specimen for analysis. Occasionally the tumour is out of reach of the bronchoscope and the biopsy has to be performed by introducing a needle between the ribs, under CT guidance, to locate the biopsy site.





What treatments are currently available to treat this disease?

It is important to identify the subtype of the lung cancer as well as the location and spread of the disease. Depending on these parameters we follow the different treatment options available:

– Surgery: Performed by a thoracic surgeon, consists in the removal of the tumour, with sufficient margins, as well as local lymph nodes.

– Radiotherapy: Small daily doses of radiation targeted at the tumour, with sufficient margins.

– Chemotherapy: Intravenous or oral medication targeted at destruction of the tumour.


In non-small cell lung cancer, when the tumour presents in its initial stages, curative treatment includes surgery, and in those cases where there is more advanced local disease it is treated with chemotherapy and radiotherapy. If the disease presents at an advanced stage, with metastatic involvement, the condition is considered incurable and treatment is based on chemotherapy. This helps to increase survival time and improve quality of life.

Small cell lung cancer is more difficult to control and treatment does not usually include surgery. When the patient presents with more localised disease, treatment includes chemotherapy and radiotherapy. If other organs are affected treatment is based on chemotherapy.


How can we prevent lung cancer?

The main strategy in lung cancer prevention is to avoid the risk factors in its development such as tobacco smoke.

Smokers can reduce their risk of developing this type of cancer by stopping smoking but they will always have a higher risk than someone who has never smoked.