Internal medicine
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Recerca:
The main research areas of the Service of Internal Medicine are:
- Venous Thromboembolic Disease
The main research consists of international multicentre cross-sectional or longitudinal clinical studies designed around the RIETE Cohort (Registro Informatizado de pacientes con enfermedad tromboembòlica). The main topics in which the Service of Internal Medicine has participated are those evaluating the efficacy of multiparametric risk calculators and those related to thromboembolic disease and cancer.
Furthermore, the service participates in independent clinical trials or those sponsored by the pharmaceutical industry.
- Addictions
The main studies in which the service participates are national multicentre studies of the CoRIS network (Cohort of the AIDS Research Network) and the National Drug Plan network. However, researchers from the Service of Internal Medicine are principal investigators on competitive grants for the study of the value of the microbiome in the progression of patients with at-risk conduits and for the study of alcoholic liver disease.
- Cardiovascular Risk
The main studies focus on cohort studies of patients with retinal vein occlusion and patients with peripheral arteropathy. Recently, a presentation at the annual congress of the Spanish Society of Internal Medicine was awarded Best Oral Communication.
- Rapid Diagnostic Unit
Research in this area relates to the cost-effectiveness of Rapid Diagnostic Units, in collaboration with the Department of Health Economics at Pompeu Fabra University.
- Other
Other lines of research include: anaemia, heart failure (in collaboration with the Cardiology department) and the improvement of care pathways.
Presentation:
Internal Medicine is the specialty that understands disease from its pathophysiological mechanisms through to diagnosis and treatment. One of its core values is the comprehensive assessment of the individual, playing a key role in coordinating and ensuring continuity of care within the hospital setting, acting as a unifying element between the various specialties. It addresses both the most prevalent conditions and highly complex clinical situations, and is particularly noted for its central role in the diagnostic process, systematically integrating symptoms, clinical signs and supplementary tests.
The Service of Internal Medicine at the Germans Trias i Pujol University Hospital is a modern, dynamic and constantly evolving service, focused on providing a flexible and efficient response to the healthcare needs of its catchment population. It is characterised by a high diagnostic capacity, especially in patients with high clinical complexity and multiple pathologies, routinely incorporating the advanced diagnostic techniques typical of a tertiary hospital.
The clinical service is provided both in the inpatient setting and in outpatient care, and has been strengthened by the introduction of tools that enable more efficient diagnoses and a more personalised approach, such as bedside clinical ultrasound and lymph node biopsies. In response to the rise in respiratory diseases among elderly patients, the service has been trained in advanced ventilatory support techniques, including non-invasive mechanical ventilation and high-flow nasal oxygen therapy. Parallel to this, it has promoted a shared care model, particularly with surgical services, as a strategy to improve coordination and the quality of care.
The Service of Internal Medicine integrates its clinical activity with teaching and research in a cross-cutting manner, as essential elements of rigorous, evidence-based clinical practice. It highlights research activity in areas such as venous thromboembolic disease, addictions and cardiovascular risk, as well as teaching in the Medicine degree at the Autonomous University of Barcelona, specialist training via the MIR programme and the organisation of accredited continuing education sessions.
Featured service news
Tipus Servei: 1
Correu: medicina.germanstrias@gencat.cat
Docència:
Undergraduate teaching
The Service of Internal Medicine coordinates the Physiopathology and Semiology module of the Medicine degree at the Autonomous University of Barcelona (UAB), and participates in the Simulation and Integrated Learning in Medicine modules.
Postgraduate teaching
- Training of Internal Medicine residents: three residents per year
- Training of residents from other specialities in accordance with the speciality's curriculum
- Training of residents from other centres: residents from other Catalan and non-Catalan hospitals attend rotations in the Service of Internal Medicine. Particularly important are the rotations through the addictions and venous thromboembolic disease clinics, and the training offered by the Service of Internal Medicine in Clinical Ultrasound.
- Training for other Internal Medicine specialists in venous thromboembolic disease
Information for residents
- 3 accredited places per year
- See the Teaching Guide
- Find out what our residents think about the Medicine Internal service of the Germans Trias
Continuous training
Examples include sessions that have been held on this topic, as well as sessions on anaemia, gender-sensitive thrombotic disease and anticoagulation. These sessions involve other hospital specialities, as well as Primary Care from the Regional Health Service.
Medical team
Cristina Tural Llàcher
Head of Internal Medicine Service
Raquel Núñez Aragón
Section Head
Joan Romeu Fontanilles
Section Head
Cristina Pacho Pacho
Specialist doctor
Juan José López Núñez
Specialist doctor
Xavier Garcia Calvo
Specialist doctor
Adrià Steinherr Zazo
Specialist doctor
Guillem Guix Camps
Specialist doctor
Yessica López Loureiro
Specialist doctor
Patricia Sigüenza Bonete
Specialist doctor
Maria Delgado Capel
Specialist doctor
Daniel Fuster Martí
Specialist doctor
Paola Zuluaga Blanco
Specialist doctor
María Larrousse Morellón
Specialist doctor
Lara Hidalgo Peña
Specialist doctor
Javier Lagullon Sabariego
Specialist doctor
Internal Medicine is the specialty that understands disease from its pathophysiological mechanisms through to diagnosis and treatment. One of its core values is the comprehensive assessment of the individual, playing a key role in coordinating and ensuring continuity of care within the hospital setting, acting as a unifying element between the various specialties. It addresses both the most prevalent conditions and highly complex clinical situations, and is particularly noted for its central role in the diagnostic process, systematically integrating symptoms, clinical signs and supplementary tests.
The Service of Internal Medicine at the Germans Trias i Pujol University Hospital is a modern, dynamic and constantly evolving service, focused on providing a flexible and efficient response to the healthcare needs of its catchment population. It is characterised by a high diagnostic capacity, especially in patients with high clinical complexity and multiple pathologies, routinely incorporating the advanced diagnostic techniques typical of a tertiary hospital.
The clinical service is provided both in the inpatient setting and in outpatient care, and has been strengthened by the introduction of tools that enable more efficient diagnoses and a more personalised approach, such as bedside clinical ultrasound and lymph node biopsies. In response to the rise in respiratory diseases among elderly patients, the service has been trained in advanced ventilatory support techniques, including non-invasive mechanical ventilation and high-flow nasal oxygen therapy. Parallel to this, it has promoted a shared care model, particularly with surgical services, as a strategy to improve coordination and the quality of care.
The Service of Internal Medicine integrates its clinical activity with teaching and research in a cross-cutting manner, as essential elements of rigorous, evidence-based clinical practice. It highlights research activity in areas such as venous thromboembolic disease, addictions and cardiovascular risk, as well as teaching in the Medicine degree at the Autonomous University of Barcelona, specialist training via the MIR programme and the organisation of accredited continuing education sessions.
Featured service news
The clinical activity of the Internal Medicine Service can be divided into inpatient and outpatient services.
Admitted patient
Hospital admission under the care of the Department of Internal Medicine. Patients may be admitted to four units depending on the reason for admission.
- Acute Geriatrics Unit
The profile of admitted patients is characterised by being elderly (>70 years old) and having a high burden of morbidity, and the reason for admission is related to the exacerbation of one or more of their chronic illnesses. It is the patient with multiple pathologies. This Unit works not only in collaboration with the various medical services of the hospital but also, and especially, with the Social Work Unit and the Service of Physical Medicine and Rehabilitation. The nurses and HCAs on the wards play an important role in the care of these patients.
A profile of patients that we have recently been attending to in the ward are those with advanced organ disease (ACMURA), generally of cardiovascular origin. These patients are previously assessed by a multidisciplinary committee composed of internists, cardiologists, geriatricians, general practitioners from the health area, doctors from the home hospitalisation unit, social workers and expert nurses, where the type of care these patients are to receive in the event of a possible hospital admission is agreed upon.
- Internal Medicine
Patients are admitted for diagnostic purposes. They are generally patients in good functional condition, but who cannot remain at home while the diagnostic process is ongoing.
- Orthogeriatrics Unit
Patients over the age of 64 with a hip fracture are admitted. The Orthogeriatrics Unit is a multidisciplinary unit composed of internists, trauma specialists, anaesthetists, social workers and rehabilitation specialists. The internist cares for the patients from the moment they arrive at the Emergency Department and follows them throughout their entire hospital stay.
- Addictions Unit
Patients are admitted for detoxification from abused drugs, with the main profile being the patient with alcohol use disorder. An increasingly common patient profile is that of someone with an addiction to benzodiazepines or designer drugs. Patients are admitted to this unit on referral from the CAS (Centres for the Care and Follow-up of Drug Dependence), following an assessment by staff with expertise in the field of addictions and by specialist nurses.
Admission of patients under the care of other medical or surgical services. The internist participates in the care of these patients by means of:
- Interconsultations: requests issued by the service responsible for the patient to the Service of Internal Medicine
- Shared care: a healthcare model in which two or more services or professional teams coordinate responsibility for the monitoring and treatment of the same patient. The Internal Medicine Service has shared care with the services of Neurosurgery, General Surgery (Hepato-biliary-pancreatic Unit), Vascular Surgery and Psychiatry.
Outpatient
Outpatient care is organised into monographic clinics. Appointments can be in person or by telephone.
- General Outpatient Clinic
It sees patients referred by the Emergency Service, inpatient services, other outpatient services or Primary Care from the health area. In general, the reasons for consultation are common conditions that present a certain non-urgent diagnostic difficulty.
- Venous Thromboembolic Disease Outpatient Clinic
Cares for patients with venous thrombosis, pulmonary embolism, hereditary coagulation disorders and antiphospholipid syndromes.
- Cardiovascular Risk Clinic
Obliterative arteriopathy and systemic diseases.
- Retinal Venous Occlusion
Together with the ophthalmology department, they form a functional unit.
- Rapid Diagnostic Unit
Rapid consultation with a waiting time of <7 days and prompt supplementary investigations.
- Outpatient Clinic for Anaemias (General) and Preoperative Anaemia
- General: patients with anaemia who require diagnosis and follow-up. The clinic is physically based in the Multidisciplinary Day Hospital, which allows for blood tests and the administration of intravenous iron.
- Preoperative Anaemia: This clinic sees patients with anaemia, with or without an established aetiology, who are candidates for elective hip or knee replacement surgery.
- Post-Discharge Clinic
Patients discharged from an inpatient stay in the Internal Medicine Service who require follow-up for a short period after discharge.
- Orthogeriatrics Outpatient Clinic
The aim is the administration of zoledronate for the secondary prevention of fractures in patients who have suffered a hip fracture.
- Addictions Clinic
For the outpatient follow-up of patients with addictions, referred from the hospital's various departments and from Primary Care.
Clinical area: Transversality and continuity of care
The Internal Medicine Service develops models of care based on transversality and continuity of care. This way of working is reflected in various resources, such as post-discharge outpatient clinics, the orthopaedics and geriatrics outpatient clinic, and collaboration with surgical services—such as Neurosurgery, General Surgery and Vascular Surgery—and Psychiatry through the shared care model. Likewise, close collaboration is maintained with the Ophthalmology, Vascular Surgery, Rheumatology and Cardiology services in the field of outpatient clinics and functional units.
Research area: established areas and emerging areas
The main established research areas are addictions and venous thromboembolic disease. Both lines of research have a long track record within the Internal Medicine Service, are constantly evolving and constitute reference areas both nationally and internationally.
Emerging areas include cardiovascular risk, with a particular focus on patient populations traditionally under-assessed from a medical perspective, such as individuals with obliterative arteriopathy and those with retinal vein occlusion. Likewise, the study of anaemia in elderly patients and the economic analysis of rapid diagnostic units stand out as emerging lines of research.
Postgraduate teaching area: continous training courses within the service
The Internal Medicine Service is a pioneer in offering its residents clinical ultrasound and ventilatory support courses taught by its own consultants, as well as update sessions on the most interesting aspects of the specialty, either through the department's weekly sessions or via multidisciplinary continuing education meetings.
The main research areas of the Service of Internal Medicine are:
- Venous Thromboembolic Disease
The main research consists of international multicentre cross-sectional or longitudinal clinical studies designed around the RIETE Cohort (Registro Informatizado de pacientes con enfermedad tromboembòlica). The main topics in which the Service of Internal Medicine has participated are those evaluating the efficacy of multiparametric risk calculators and those related to thromboembolic disease and cancer.
Furthermore, the service participates in independent clinical trials or those sponsored by the pharmaceutical industry.
- Addictions
The main studies in which the service participates are national multicentre studies of the CoRIS network (Cohort of the AIDS Research Network) and the National Drug Plan network. However, researchers from the Service of Internal Medicine are principal investigators on competitive grants for the study of the value of the microbiome in the progression of patients with at-risk conduits and for the study of alcoholic liver disease.
- Cardiovascular Risk
The main studies focus on cohort studies of patients with retinal vein occlusion and patients with peripheral arteropathy. Recently, a presentation at the annual congress of the Spanish Society of Internal Medicine was awarded Best Oral Communication.
- Rapid Diagnostic Unit
Research in this area relates to the cost-effectiveness of Rapid Diagnostic Units, in collaboration with the Department of Health Economics at Pompeu Fabra University.
- Other
Other lines of research include: anaemia, heart failure (in collaboration with the Cardiology department) and the improvement of care pathways.
Undergraduate teaching
The Service of Internal Medicine coordinates the Physiopathology and Semiology module of the Medicine degree at the Autonomous University of Barcelona (UAB), and participates in the Simulation and Integrated Learning in Medicine modules.
Postgraduate teaching
- Training of Internal Medicine residents: three residents per year
- Training of residents from other specialities in accordance with the speciality's curriculum
- Training of residents from other centres: residents from other Catalan and non-Catalan hospitals attend rotations in the Service of Internal Medicine. Particularly important are the rotations through the addictions and venous thromboembolic disease clinics, and the training offered by the Service of Internal Medicine in Clinical Ultrasound.
- Training for other Internal Medicine specialists in venous thromboembolic disease
Information for residents
- 3 accredited places per year
- See the Teaching Guide
- Find out what our residents think about the Medicine Internal service of the Germans Trias
Continuous training
Examples include sessions that have been held on this topic, as well as sessions on anaemia, gender-sensitive thrombotic disease and anticoagulation. These sessions involve other hospital specialities, as well as Primary Care from the Regional Health Service.
Contacte: medicina.germanstrias@gencat.cat