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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.
Dr. Tomas Pumarola, Dr. Andrés Antón, Dr. Magda Campins, Dr. Xavier Martínez, Dr. Benito Almirante, Dr. Assumpta Ricart, Dr. Carlos Rodrigo, Dr. Sebastián González.
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.
It is a chronic brain disorder that can affect people of any age. It is characterised by recurring convulsions caused by excessive electrical impulses in groups of brain cells. The consequences can be neurological, cognitive, psychological and social.
In 2005, epilepsy was defined as “a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures”. Epilepsy is therefore diagnosed when patients experience two or more seizures, separated by a period of time that can last from 24 hours to 10 years.
Epilepsy causes brief absence seizures, involuntary movements, repetitive reflexes such as sucking movements, loss of consciousness, and so on. It can originate in one area of the brain (focal seizure) or the brain as a whole (generalized seizure). Seizures are sometimes accompanied by loss of consciousness and/or loss of bowel control. Their frequency can vary from only just one over a ten year period to several per day.
Seizures (absence seizures, muscle contractions, etc.) are the main symptom and may vary depending where in the brain the epileptic seizure begins.
For example, in tonic-clonic seizures (GTCS), it is common to observe twitching, muscle contractions, jerking, etc. These movements are called “myoclonus” and may be symmetric or asymmetric and are accompanied by rolling of the eyes. They are followed by a spasm with clenching of the teeth, laboured breathing and an epileptic shout.
Epilepsy affects the entire population, regardless of age, from whilst still in the womb right up to people in their nineties. It is estimated that 8 in 1000 people have the condition.
Related factors:
In some cases the cause of epilepsy may be unknown, as although we can see an epileptic seizure occurring in the brain, current technologies do not reveal what causes them. Epilepsy may also be genetic.
It is the second most common neurological disorder (after stroke) seen in accident and emergency departments. An estimated 3,000 patients are seen in our centre every year. 3% of the population will attend a medical centre at some point during their lifetime to determine whether their symptoms are caused by epilepsy.
Diagnosis requires:
It is advisable to avoid all situations that may create:
When faced with a seizure, a series of recommendations should be followed to avoid injury to the person having the seizure.
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