Paediatric Neurology offers comprehensive care for children with neurological disorders, from common problems such as headaches or neurological follow-ups of at-risk new-borns to complex, heterogeneous and rare illnesses that are difficult to diagnose, such as neuromuscular diseases, epileptic encephalopathies and neurometabolic and neurodegenerative diseases.

The work carried out by this Section in the fields of research and teaching is especially important, and we participate in national and international networks, working groups and various patient associations. The Section is accredited as a Spanish Reference Centre (CSUR) in ataxia and paraparesis, neuromuscular diseases and metabolic diseases, and is a European Reference Network centre (ERN) for rare neurological diseases, neuromuscular diseases and metabolic diseases.  

Quality care requires early diagnosis, treatments that are suitable and specific to each patient and support for the emotional and social aspects of the child and his or her close relatives. In addition to the different healthcare professionals (from neuropaediatrics, pneumology, rehabilitation, traumatology, cardiology, nutrition and gastroenterology, nephrology and urology, among others), our multidisciplinary teams include nursing staff, physiotherapists, speech therapists and psychologists, to make sure we are able to carry out this work effectively. We also rely on the indispensable collaboration of highly qualified professionals from the Paediatric and Neonatal Intensive Care Units and Accident and Emergency Department for complications that often affect those with neurological diseases. These professionals, alongside those from the Palliative Care Unit, are highly experienced in the fields of neuroradiology, clinical neurophysiology and neuropathology.

Finally, all the staff members take part in different weekly clinical sessions (general paediatric neurology, neuroradiology and epilepsy sessions), monthly sessions (neuromuscular, metabolic and genetic diseases), as well as multidisciplinary meetings and committees aimed at reaching consensus and optimising the oversight and treatment of patients.

In the area of neurometabolic diseases, we collaborate in the neonatal screening programme for the detection of 23 different diseases, which has allowed us to increase our knowledge in the natural history of these diseases, mainly in lysosomal diseases.

Research

Both basic and clinical research are essential, and they represent a significant portion of this Section's activity. The group's researchers have set up the Paediatric Neurology Research Group, which develops clinical research in hospitals and basic research, applied to the Vall d'Hebron Research Institute (VHIR). Since 2009, it has been a member of the Consolidated Research Group for the University and Research Grant Management Agency (AGAUR).

Teaching 

Teaching activity in our Section includes undergraduate, postgraduate and continuing education of professionals in the different areas of our specialty. Our Section constantly hosts paediatric and neurological residents from the HUVH and other hospitals in Catalonia, the rest of Spain and the EU as well as South America.

We should also highlight our organisation of a master's programme in Paediatric Neurology at the Autonomous University of Barcelona, one of just two on-site master’s programmes in the sub-specialty in Spain. We also organise an annual refresher course in Paediatric Neurology and help coordinate the Master's Degree in Translational Biomedical Research at the VHIR.

The Adolescent and Adult Congenital Heart Disease Unit (UCCAA) was set up at Vall d'Hebron University Hospital more  than 40 years ago, and we have been providing paediatric care for congenital heart diseases ever since. This Unit is the result of a collaboration agreement between our Hospital and the University Hospital of Santa Creu i Sant Pau, to bring together the effort, resources and experience of these two leading hospitals in the treatment of this disease.

Outpatient visits to the UCCAA Unit take place in the Outpatient Clinic of the Maternity and Children's Hospital, next to the Paediatric Cardiology Department, meaning we can group outpatient care for cardiology of congenital heart disease in a single area. This means that we can share work stations, databases and tools (the ECO 3D) and it makes the transfer and continuity of treatment simple, from paediatric age to adulthood, for what is a congenital and life-threatening disease.

Patients who require admission are directed to the General Hospital, and stay in the cardiology ward. Depending on their clinical circumstances, some of these adult patients with congenital heart disease must be admitted onto special wards:

• Patients in critical condition: Coronary and Intensive Cardiological Care Unit of the Cardiology Department.
• Patients just out of operations: Cardiology Department Postoperative Cardiac Surgery Unit.
• Pregnant patients with congenital heart disease: the Obstetrics, Foetal Medicine and Anaesthesia Departments have created a Working Unit for High-Risk Pregnancies for women with congenital heart disease. Following an established protocol, the checks carried out by the Obstetrics Unit are set to match any necessary cardiac checks to monitor the well-being of mother and foetus during pregnancy, birth and postpartum, with a care protocol that accounts for both the heart disease and the clinical circumstances. We also provide care for cases of postpartum with cardiological risk.

In parallel with these services, there is also a clinic for reproductive counselling for women with congenital heart disease. This clinic is a part of the Adolescent and Adult Congenital Heart Disease Unit (UCCAA), carried out jointly with the Gynaecology Department at the Outpatient Clinic of the Maternity and Children's Hospital. There, a cardiologist and a gynaecologist/angiologist, experts in congenital heart disease, work together to analyse the patient depending on their individual clinical and heart disease condition and explore their chances of conceiving children. Their mission is to inform, evaluate and offer sexual health planning, discussing the reproductive possibilities of the patients living with congenital heart disease.

Our Department has a long tradition of applying diagnostic techniques in the various fields of neurophysiology, and we provide services to patients from a large number of medical and surgical specialties, such as neurology, neurosurgery, traumatology, rehabilitation, pneumology, paediatrics, internal medicine, ENT, intensive care medicine, ophthalmology, urology and family medicine, etc.

The incorporation of new diagnostic techniques, ever greater complexity and advances in the area of knowledge have all furthered the Department’s specialisation in a range of areas of knowledge:

• Electroencephalography, to measure the electrical activity of the brain
• Electromyography, to verify the health of the muscles and nerves that control them
• Evoked potentials, a diagnostic technique that is used to explore the nerve pathways that bring information from the sensory organs to the brain
• Sleep Unit 

The main objectives of this Department are:

• Support in diagnosing diseases of the nervous system, in which we offer the patient and the requesting doctor maximum guarantees and expertise in carrying out diagnostic techniques.
• We ensure there will be no functional damage to the nervous system pathways in risky procedures, such as surgery (neurosurgery, spinal column and peripheral nerve).
• We help further knowledge of the physiopathology of nervous system diseases in order to be able to transfer this knowledge to the clinical field.
• We also participate in passing on knowledge by training professionals.

At the Neurosurgery Department, we apply the most advanced technologies and a multidisciplinary approach in a context that allows us to train neurosurgeons with strong ethical and moral values. All this, as part of the public health system that is accessible to all citizens.

Our Department is divided into three physically separate care sections located in three areas of the Vall d'Hebron hospital complex: the General Hospital, the Traumatology, Rehabilitation and Burns Hospital and the Maternity and Children's Hospital. Finally, the Neurotraumatology and Neurosurgery Research Unit, which integrates all of the Department’s translational research, complements these three care sections, applying the knowledge garnered from basic research to the prevention and treatment of clinical cases.

The General Hospital is home to most of the Neurosurgery Department’s activity, housing most of its human resources, patients, beds and financial resources. The team is made up of a chief clinician, seven specialist doctors and a Head of Department. Three of the doctors share their activities with the Maternity and Children's Hospital, and form the main group of physicians devoted to paediatric neurosurgery. The other doctors also collaborate on neuropaediatric care, both with emergency care and low-prevalence pathologies, in which our Department is super-specialized. Adult patients are admitted here who have had cranioencephalic trauma and a programmed pathology of the rachis (spine).

Portfolio of services 

The care offered by the Neurosurgery Department covers three fundamental aspects: general neurosurgery (adult patients), neurotraumatology and paediatric neurosurgery. Despite this differentiation, we are a cross-cutting department that addresses the following diseases:

General neurosurgery in adult and paediatric patients

• Neurooncology
• Haemorrhagic neurovascular pathology (cerebral aneurysms, arteriovenous malformations, hard fistulas)
• Ischemic neurovascular pathology (decompressing surgery in malignant infarction of the middle cerebral artery, cerebral revascularisation)
• Hydrocephaly and complex pathology of the dynamic of the cerebrospinal fluid that surrounds the brain and the spinal cord
• Malformations in the craniocervical hinge
• Surgery of the base of the skull
• Evacuation of abscesses and treatment of infectious pathologies of the central nervous system
• Neuroendoscopy
• Radiosurgery
• Spasticity not responsive to pharmacological treatment
• Acute and degenerative spinal pathologies
• Repair of congenital malformations of the nervous system

Neurotraumatology in adult and paediatric patients

• Acute surgery of cranioencephalic trauma
• Multimodal neuromonitoring in severe cranioencephalic trauma
• Surgical repair of cranial fistulae of cerebrospinal fluid
• Surgery to repair cranial vault injuries (cranioplasty)

Teaching

The educational mission of any neurosurgery department at a high-tech hospital does not end with the training of undergraduate students and specialised training, but rather we are devoted to continuing training of all doctors with links to neurosurgery.

Our Department organises several clinical sessions, as well as annual doctoral courses and different continuing education programmes aimed not only at residents and neurosurgeons in the Department, but also specialists in intensive care, anaesthesia and, in some cases, nursing staff. On the other hand, most of our sessions offer a considerable number of continuing education credits.

The training programme for residents at the Neurosurgery Department includes a general educational programme, a rotation scheme, a plan detailing the objectives and surgical skills that must be acquired, the obligation to comply with the "Resident’s Logbook" and an appropriate evaluation system.

One essential aspect that is often overlooked is the importance of the role of nursing staff in neurosurgical care. We are keenly aware of this, and for years now the neurosurgery nursing staff at the General Hospital and the Neurotraumatology ICU have been integrated in the educational activities of the Department. Also, a symposium specific to nursing is included in the International Symposium on the Monitoring of Intracranial Pressure and Cerebral Haemodynamics that is celebrated biannually. The management of this event, as well as the contents and speakers chosen, falls to the nursing staff, who have total autonomy in organising their Symposium.

Our Department is aimed at preventing kidney disease in children through early diagnosis, including prenatal diagnosis. In the case of children with chronic kidney disease in substitute treatment, we offer vital support with dialysis techniques. In the case of chronic terminal kidney disease, we offer kidney transplants as the best therapy.

Our team uses extracorporeal techniques, both in primary renal pathology and for preserving and prolonging the functionality of the kidney transplant (plasmapheresis, immunoabsorption, etc.).

We provide care and treatment for children with non-kidney pathologies with an impact on kidney function, especially in patients with chronic pathologies, such as solid organ transplants, bone marrow transplants and syndromes that affect the kidney, survivors of chemotherapy and nephrotoxicity.

Vall d'Hebron Hospital was the first centre in Spain to carry out a liver transplant in a child in 1985.

Portfolio of services 

• Hydroelectrolyte alterations originating in the kidney: sodium and water disorders, potassium disorders, calcium and phosphate disorders, magnesium disorders
• Acid-base changes originating in the kidney: tubular acidosis
• Neonatal disorders of kidney function
• Study and treatment of malformations in the kidney and hereditary neurological diseases
• Tubulopathies
• Glomerulopathies
• Renal manifestations of other extrarenal diseases
• Vasculitis
• Tubulointerstitial nephropathies
• Infection of the urinary tract and infectious processes
• Uropathies (in coordination with the Paediatric Urology Section)
• Nephrocalcinosis and kidney stones
• Nephrourological tumours (in coordination with the Paediatric Oncology Department)
• Nephrotoxicity resulting from chemotherapy and radiotherapy
• Arterial hypertension
• Acute renal failure
• Chronic renal disease
• Renal disease in recipients of other solid organ transplants
• Renal disease in bone marrow transplant recipients
• Kidney transplant. Official Reference Centres, Departments and Units of the Spanish National Health System (CSUR)

Extrarenal depuration techniques 

• Continuous arteriovenous and venovenous haemo(dia)filtration
• Acute and chronic peritoneal dialysis
• Acute and chronic haemodialysis
• On-line haemodialysis
• Plasmapheresis
• Immunoabsorption
• Lipid apheresis. Reference centre
• Granulocyte apheresis

Research

• Research into corticoresistant nephrotic syndrome within the Renal Physiology Group of the Research Institute
• Research into growth retardation in chronic kidney disease
• Research into erythropoiesis stimulators in chronic kidney disease
• Research into calcium-regulating hormones in different renal pathologies
• Research into immunomodulatory mechanisms in kidney transplants
• Clinical trials with ferumoxitol in chronic kidney disease anaemia
• paracalcitol at stage 4 of MRC

Ours is a transversal department, meaning we collaborate with many other medical and surgical departments at the Hospital. Our ability to provide support in all healthcare areas guarantees coordinated care for patients throughout their stay. We are a reference centre in Catalonia for various highly complex processes (spinal cord injury, acquired brain damage, spina bifida, burns) and we also engage in teaching and research.

At the Physical Medicine and Rehabilitation Department, we collaborate directly with various other medical and surgical departments at the hospital and share multidisciplinary patient care units. We are involved in virtually all units that deal with rare illnesses.

At our Department, in addition to doctors specialising in physical medicine and rehabilitation, we also have physiotherapists, occupational therapists, speech therapists, auxiliary technicians in nursing care, monitors and administrative staff. Teamwork is the defining feature of our specialty. Our multidisciplinary rehabilitation team also includes specialised nursing staff, an orthopaedic technician and a social health worker.

Our cross-cutting department consists of two main areas of care, community and tertiary: we assist patients in our catchment area but also those from elsewhere who need highly specialised care. We work in an acute hospital where increasingly complex cases are handled, and we aim to adapt to ensure hospital stays are as short as possible.

At the Neurorehabilitation Day Hospital, patients who have a neurological disability and need comprehensive rehabilitation treatment can receive it in a single place, and, if they do not require nursing care, they can sleep at home.

Our Department works in three main areas: Osteoarticular, Neurorehabilitation and Specific Pathologies.

Portfolio of services

Osteoarticular

• Spina bifida, congenital malformations that affect the spine, and Rett's syndrome in adults, and disorders of the nervous system that cause problems in the development of children.
• Osteoarticular rehabilitation (traumatology, orthopaedics and vertebral deformities)
• Vertebral Pain and Deformities Unit

Neurorehabilitation

• Officially accredited as a CSUR centre of reference (Reference centres, departments and units), the Spinal Cord Injury Unit is a reference centre in Catalonia and the rest of Spain for the treatment of people who have suffered spinal cord injuries. We offer comprehensive care in cases of acute and subacute spinal cord injuries. We offer physiotherapy, occupational therapy, sphincter re-education, infiltration treatment with botulinum toxin, risk assessment of injuries caused by a blow or by diseases, assessment of support for sitting independently.

• Neurological rehabilitation. We offer comprehensive, intensive care, where required, to patients with strokes, cranial traumatism or acquired brain damage in general. We offer treatments involving physiotherapy, occupational therapy, speech therapy, swallowing disorders and neuropsychology. At the Day Hospital, we provide neurorehabilitation (physiotherapy, occupational therapy, swallowing disorders and neurorehabilitation). We apply rehabilitation techniques using virtual reality, and offer infiltration treatments using botulinum toxin.

• Child rehabilitation. We treat patients with neurological pathologies (caused before, during or after delivery), medical or traumatic pathologies, muscular pathologies, tumoural or orthopaedic pathologies, and multilevel surgery. We offer multidisciplinary care with neonatology, neuropaediatrics, neurosurgery, orthopaedic surgery, nutrition and neuropsychology. We have physiotherapy, occupational therapy and neuropedagogy, and we apply infiltration treatments with botulinum toxin. We have a Marfan Syndrome Unit.

Specific pathologies

• Cardiorespiratory rehabilitation (in adults and children). We offer respiratory rehabilitation with a special emphasis on the programme for chronic obstructive pulmonary disease (COPD), cystic fibrosis, amyotrophic lateral sclerosis (ALS), lung transplants, cardiac rehabilitation for acute coronary syndrome and heart failure.
• Pelvic floor. Care for mixed and urgent urinary incontinence, both in men and women, and individual treatment with instrumental techniques and exercises.
• Phoniatrics, speech therapy and swallowing disorders. This is the only unit of its kind in the public health system in Catalonia that covers all pathologies of language, voice, speech and hearing, as well as swallowing disorders. We perform early detection of childhood hearing loss in high-risk infants with the collaboration of the Otolaryngology Department (ENT) and the Neurophysiology - Evoked Potentials Department for children. Checks and monitoring of children with hearing loss, prescription of hearing aids, relationship with CREDA and participation in the rehabilitation programme for cochlear implants, to stimulate the auditory nerve, with the Otolaryngology Department (ENT). We use videolaryngostroboscopy and instrumental analysis of the voice.
• Burn rehabilitation. We offer comprehensive care to burns patients in close collaboration with the Burns Unit, part of the Plastic and Repair Surgery, as well as for transplant patients. Physiotherapy and occupational therapy.
• Rehabilitation of amputees. We provide care for amputees, of both upper and lower limbs, with the most appropriate, functional prostheses, and offer training in how to use them, both for children and adults.
• Rehabilitation in breast and lymphoedema pathologies. We provide comprehensive care for oncological patients, both during and after surgery to see how patients recover. We offer physiotherapy with techniques involving pressotherapy, manual lymphatic drainage, multi-layer compression, individual and group kinesiotherapy, Nordic walking and open group follow-up. We treat lymphoedemas, which are disorders of sensitivity, both in the upper limb and in the lower limb.
• Rehabilitation of facial paralysis. We offer care for peripheral facial paralysis of various causes from the acute phase, with physiotherapy and botulinum toxin infiltration techniques, where appropriate.
• Haemophilia rehabilitation unit. We offer specific care for patients with haemophilia or coagulopathy with multidisciplinary checks. We place special emphasis on prevention and/or treatment of joint conditions with haemophilia arthropathy.
• Rehabilitation of balance disorders. We apply specific physiotherapy treatment techniques, both individually and in groups.
• Unit for Assessment Tests Using Instruments. Functional respiratory tests, effort tests, isokinetic exercise analysis, gait study and vestibular tests (for balance disorders).

At our Unit, we use the most advanced technology, so we can offer highly sophisticated examinations and treatments both for the foetus, which becomes a patient before birth, and the mother, who presents very high risk problems, for herself and for the foetus or baby.

Quality, personalised care during gestation requires different highly specialised units that help in possible complications of the mother and the foetus. For mothers, we have an Intensive Care Medicine and Intermediate Obstetric Care Department; for babies, we offer families the most advanced procedures and technology in diagnosis, management and intrauterine neonatal treatments.

Some of the diseases we deal with are:

• Prevention of premature labour with a cervical pessary, a silicone ring that is placed in the cervix and guarantees in almost 100% of cases that the 37 week minimum gestation is respected
• Placental insufficiency and growth restriction
• Maternal infections and how these affect the foetus, malformations, infections, foetal transfusions, complicated and uncomplicated pregnancies with twins.
• We are also pioneers in diagnosis and treatments, such as foetal surgery, especially in cases of foeto-foetal transfusion between monochorionic twins, as well as high risk ultrasounds and prenatal invasive and non-invasive diagnosis.

Research 

The Department set up the Maternal and Foetal Medicine Research Group, recognised by both Catalan and Spanish research agencies, which works at the Vall d'Hebron Research Institute and promotes basic and applied research, and the host laboratories at Vall d'Hebron.

The Maternal and Foetal Medicine Research Group is part of the Division of Obstetrics, Paediatrics and Genetics, and is made up of a network of interdisciplinary researchers in basic and clinical sciences with a shared focus of interest.

Teaching

Our state-level centre enjoys European recognition for the training of EBCOG residents EBCOG (European Board and College of Obstetrics and Gynaecology) and the EAPM (European Association of Perinatal Medicine). We are also the first centre accredited for the training of Fellows2 in gynaecological oncology and breast pathologies by the ESGO (European Society of Gynaecological Oncology).

In our Unit, we treat infants with infections and immunodeficiencies, a pathology that has become increasingly important in recent years. This increase in cases is due to several reasons, such as the emergence of AIDS, the emergence of almost forgotten pathogens, the importing of diseases from other geographical areas, the increase in opportunistic infections as a consequence of more aggressive treatments and more invasive diagnostic techniques, and the presence of new patterns of microbial resistance. This is in addition to the significant differences between treating children and adults. For this reason, our discipline is constantly being reviewed and updated, and is a key specialty for all hospital centres.

Our Unit was created in January 1996, as a hospitalisation unit dedicated to the study and treatment of paediatric illnesses of infectious origin, and in June 2004 it also incorporated the day hospital and the Outpatient Clinic for HIV and Primary Immunodeficiencies. A year later, at the initiative of the centre's management, it consolidated itself as a modern infectology unit, taking over consultation functions in the diagnosis and control of complex infection of critical and immunodepressed patients as well as patients from various paediatric specialties. We went on to incorporate the Outpatient Clinic for Infectious Community Diseases (contracted outside the hospital), Vertical Transmission Infections (from mother to child) and Pathologies, such as tropical diseases.

Portfolio of services

• Infectious pathology consultation service for healthy immunosuppressed children

• Hospitalisation for infectious pathologies and immunodeficiencies

• Genetic counselling and risk assessment for immunodeficiencies

• HIV Outpatient Clinic

• Vertical Transmission Infections Outpatient Clinic

• Community Infectious Diseases Outpatient Clinic

• Primary Immunodeficiencies Outpatient Clinic

• Imported Illnesses Outpatient Clinic

• High resolution clinic

• Second opinion Clinic

• Interhospital Clinic

• Digital Clinic

• “I’m not alone” programme

• Specialised psychosocial care

Teaching

• Undergraduate training at the Autonomous University of Barcelona (UAB)

• Training programme for residents

• Monthly teaching sessions with ten hospital centres, using telemedicine

• Bi-weekly clinical sessions: Tuesday, at 3:00 p.m.; Thursday, at 8:15 a.m.

• Annual continuing education courses: paediatric infectology course and national IFI course

• Master's in paediatric infectology by the UAB.

• Protocols and sessions

Research

The Unit participates in multiple studies and clinical trials, leading many of them. It is also home to the Infections in the immunocompromised paediatric patient research group. The main research lines of the Unit are:

• Safety, efficacy and tolerance of anti-infectious agents

• Family epidemiologic study of primary immunodifficiencies

• Vertical transmission of HIV, Chagas and HTLV

• Evolution of C/N infection by gram-positive cocci and "Candida"

• Hidden hepatitis B virus (HBV) infection in immunocompromised patients

• Hospitalisation risk factors for influenza A (H1N1)

We give nutritional and diet support to hospitalised patients across all clinical departments at the Hospital, and carry out follow-up monitoring at outpatient care for those patients who need it. We also provide outpatient care for patients referred from other healthcare areas of the Hospital and primary care centres that require specialist nutritional and dietary support. Patients requiring nutritional support are treated at the Horta Primary Care Centre. We actively collaborate in educational programmes to detect nutritional problems and for home monitoring of enteral nutrition, that is, feeding via a tube.

As a transversal unit, we support the General, Maternity and Children’s and Traumatology, Rehabilitation and Burns Hospitals, as well as the Primary Care Office in Sant Andreu; we also collaborate with a range of different medical and surgical specialties. We also participate in and direct a number of joint protocols with various other areas of the Hospital, and we maintain a very close working relationship with the Pharmacy Department, both in developing artificial nutrition and in selecting nutritional products. We act together with the Biochemistry Department in monitoring the nutrition of patients and in pursuing lines of research. We also provide support for the Pere Virgili Health Park.

We work to educate patients and family members, as well as providing courses for our staff through our continuing education programme, and we collaborate on continuing education in primary care. We organise training courses for primary care nursing staff, nursing staff from the Hospital and our orderly staff. We also educate patients and relatives about managing enteral nutrition, parenteral nutrition, as well as nutrition in cases of nephrology and inflammatory bowel disease.

Portfolio of services 

During a hospital stay, the nutrition support we provide might cover:

• Diet: adapted and/or personalised diet. In some cases where a conventional diet is not able to meet the needs of patients, nutritional supplements are prescribed.
• Artificial nutrition (enteral or parenteral) according to protocol. Prescription, preparation and monitoring of efficacy and safety of the treatment.

Once a patient has been discharged, we continue to monitor nutritional treatment through:

• Home nutrition programmes (enteral and parenteral)
• Nutritional evaluation and support through consultations
• Daily consultations with a nutritionist
• Preparation of diets after discharge for different diseases

In short, we prepare diets for hospital patients, always taking into account menu alternatives, menus for treatment and diet changes depending on patient cycles. We work together with the Catering Unit to organise and prepare the hospital’s catering operation.

Finally, we also take care of preparing and distributing baby bottles, baby food and special liquid meals for healthcare units, as well as collecting and cleaning utensils.

Teaching

Our teaching work includes:

• Training undergraduate doctors and specialists in endocrinology and nutrition in accordance with the medical residency programme
• Undergraduate training in diet and human nutrition (University of Vic, University of Navarre, University of Barcelona, Blanquerna University, Polytechnic University of Valencia, University of Zaragoza)
• Degree in Dietetics and Human Nutrition (University of Barcelona, Blanquerna University)
• ERASMUS exchange programme for dietitians (Portugal, Mexico, Italy)
• Extended visits for dietitians from abroad (Argentina, Mexico)
• Postgraduate training: Master's degree in nutrition from the Autonomous University of Barcelona (Autonomous University of Barcelona, University of the Balearic Islands, University of Granada)
• Periodic clinical sessions: reviews and clinical cases