Noticias

• Professionals from the Emergencies Section of the Navarre Health Service, along with volunteer firefighters and workers from the University Hospital Center of Toulouse and Navarrabiomed participated today in the installation of the mobile emergency unit at the Refena Conference Center within the framework of the European EGALURG network.

The Europe Occitania Multipurpose Mobile Unit (UMPEO), built by the University Hospital Center of Toulouse (CHUT) within the framework of the EGALURG European cross-border cooperation network to improve emergency and disaster healthcare in the Pyrenees, was installed today at midday in the Refena Conference Center parking lot in Pamplona / Iruña.

As part of the strategy for vaccination, Navarre has welcomed the emergency healthcare unit with the aim of administering the COVID-19 vaccine. Primary care management professionals from the SNS-O and Navarrabiomed will coordinate the movements of the emergency unit as it travels to different towns in Navarre in January and February.

The unit will provide support for vaccination of dependent people, social health personnel, home care services and primary care professionals working in rural basic health zones. Specifically, the mobile unit will travel from Refena to different towns, including Altsasu / Alsasua-Etxarri, Irurtzun, Oronoz-Mugaire, Sangüesa / Zangoza, Carcastillo, Peralta / Azkoyen, Lodosa, Los Arcos, Estella / Lizarra. In each town, the mobile unit will act as a key vaccination center so that this procedure does not have to be given at healthcare centers, thus keeping them from becoming overcrowded. This is expected to reduce the risk of infection and speed up the vaccination process.

At the event, Diego Reyero Díez, Head of the Emergencies and Primary Care Transport Section, said that the emergency unit will provide optimal conditions for COVID-19 vaccination. He said, “The mobile emergency unit has separate areas for greater comfort and flexibility for vaccination.”

Kiko Betelu Corcuera, Assistant Director of Emergency Services and Technical Director of Vital Urgency Care in Navarre, pointed out that the mobile unit can also be used to raise awareness about vaccination and the importance of so-called herd immunity. “The increase in the vaccinated population will mark a turning point in the pandemic, so the faster that happens, the better,” said Betelu.

Innovative infrastructure in Europe

To make use of the UMPEO emergency unit, a team of professionals from the Emergencies Section of the Navarre Health Service and Navarrabiomed spent Monday and Tuesday (January 11-12) in Toulouse receiving technical training on installation deployment and handling from the CHUT, the EGALURG Project leader and also the institution responsible for building the mobile unit.

As explained by Anna Ribera Cano, an emergency services doctor from Toulouse Emergency Medical Services, another member of the EGALURG Project, “This mobile unit is unique in Europe because it can be deployed so quickly. It can be operative in 20 to 45 minutes.

 As a hospital care support facility, it can handle as many as 18 patients at a time”.

The facility is designed to admit patients in intensive care beds, eight absolute emergency beds and 10 relative emergency beds, in five fully equipped subunits. It takes up a maximum area of 66 m2 and is 12 meters long. Though the mobile unit was originally designed to be used in the cross-border area at major events and mass gatherings, and to provide response services in emergencies and disasters, its construction deadlines were tightened and its design was adapted in light of the current pandemic.

Also participating in the event was Tomás Belzunegui Otano, the Scientific Director of the EGALURG Project, who said, “Though the current pandemic has made implementing the EGALURG Project more difficult, the institutions involved have continued working together on all planned actions. Being able to bring the mobile hospital to Navarre highlights the direct advantages of cross-border regional cooperation.”

The mobile unit has also been used in remote regions of Haute-Garonne to perform massive PCR testing and was deployed in Bayonne, France, to provide support for emergency services at the Hospital Center of the Basque Coast (CHCB), which was overwhelmed by the pandemic. After being installed in Navarre, plans include enabling the UMPEO to be used in coming months by the Emergency Medical Services of Catalonia (SEM) and the Aragon Health Service.

EGALURG cooperation network

The EGALURG consortium is headed by the CHUT, and its partners include Navarrabiomed, the CHCB and the SEM. The European network started operating in 2019 and will have a total duration of 30 months.

Its goals include harmonizing protocols for more effective use of healthcare resources. Developing innovative tools is one of the key parts of the project and is reflected in the mobile hospital, as well as a platform that will simulate emergency situations and help train healthcare personnel so they are prepared for these cases. Navarrabiomed is in charge of this platform.

The project is co-funded (65%) by the European Regional Development Fund (ERDF) through the Interreg Program V-A Spain-France-Andorra (POCTEFA 2014-2020). The goal of the POCTEFA program is to strengthen the economic and social integration of the Spain-France-Andorra cross-border area. Its help is focused on developing cross-border economic, social and environmental projects through joint strategies in favor of sustainable regional development.

Miren Altuna Azkargorta, a predoctoral researcher at Navarrabiomed’s Neuroepigenetics Unit, will defend her doctoral dissertation for the Universidad Pública de Navarra on Thursday, January 14. The defense will take place via videoconference and with limited attendance at 12 noon in the Navarrabiomed assembly hall (only people with prior authorization are permitted to attend the event in person). While preparing her dissertation, “Identification of epigenetic biomarkers in Alzheimer’s disease,” Miren Altuna was supervised by Maite Mendioroz Iriarte, a Navarrabiomed researcher and neurologist at the Hospital Complex of Navarre, and CHN internist Gregorio Tiberio López, her dissertation advisor.

Alzheimer’s disease (AD) is a neurodegenerative disease and the most common cause of dementia. In the last few decades, its prevalence has increased as a result of the aging population. AD is a multifactorial disease in that both genetic and environmental risk factors contribute to the disorder, although its pathogenesis is not yet fully understood. The study of epigenetics therefore plays a key role. Epigenetic mechanisms, which are partially inherited but can also be altered by environmental factors, modify gene expression without changing the DNA sequence.

The work of Miren Altuna aims to identify a footprint of DNA methylation (the most widely studied epigenetic mechanism) typical of AD by using the human hippocampus, an area of the brain that is particularly affected by the pathogenic mechanisms of AD. To achieve this, different strategies were used: (1) The study of DNA methylation changes by means of the genome-wide strategy, and (2) The study of changes in the methylation pattern for a given gene, in this case the PLD3 gene (it has previously been reported that a polymorphism of this gene increases the risk of developing AD).

The findings included identification of a differentially methylated pattern affecting the genes involved in neurogenesis in the hippocampus and differential methylation of the alternative promoter region of the candidate gene PLD3. It has been hypothesized that changes in DNA methylation could contribute to alterations in the regulation of neurogenesis previously described in the hippocampus of subjects with AD and that the risk conferred by the PLD3 gene in the development of AD may be related to changes in its epigenetic regulation.

The results presented support the existence of a specific epigenetic footprint of AD that could potentially be useful as a source of diagnostic and/or prognostic biomarkers and could therefore lead to progress in the knowledge of the pathogenesis of AD and the potential identification of future therapeutic targets. These findings have been published in three articles in indexed journals: Clinical Epigenetics (https://doi.org/10.1186/s13148-019-0672-7 and https://doi.org/10.1186/s13148-018-0547-3) and Neurología.

Miren Altuna also made her doctoral work public at the 2017 and 2019 international congresses of the European Academy of Neurology and at the 69th annual meeting of the Spanish Society of Neurology in 2017.

Pedro Dorado, a predoctoral researcher at Navarrabiomed’s Microbial Pathogenesis Unit - IdiSNA, will defend his doctoral dissertation for the Universidad Pública de Navarra via videoconference at 11:00 a.m. on Friday, January 8, in the Navarrabiomed assembly hall (only people with prior authorization are permitted to attend the event in person).

The dissertation, “Genetic tools derived from Staphylococcus aureus for the development of biotechnological applications in gram-positive bacteria,” was prepared at Navarrabiomed under the supervision of Iñigo Lasa Uzcudun, director of the center and principal investigator in the Microbial Pathogenesis Unit, and Cristina Solano Goñi, a researcher in the same unit.

Staphylococcus aureus intermittently colonizes the skin of 20% of adults. Under certain circumstances, bacteria cross the epithelial barrier and reach the internal organs, where they become a highly versatile pathogen with the capacity to cause a range of problems, including mild infections (boils and abscesses) and very serious diseases such as endocarditis, osteomyelitis, pneumonia and toxic shock syndrome. As part of this dissertation, Staphylococcus aureus virulence factors were used to develop biotechnological tools applicable to gram-positive bacteria.

In the first chapter, elements used by Staphylococcus aureus to adhere to tissues and medical implants were used to enhance the biotechnological capabilities of the environmental bacterium Rhodococcus erythropolis. The second chapter of the dissertation focuses on the study of the evolution of mobile genetic elements known as plasmids to understand how antibiotic resistance genes are maintained and spread when the antibiotic is not present. Finally, the third chapter concerns phage therapy and focuses on the development of defective phages carrying a CRISPR-Cas9 system aimed at the destruction of antibiotic-resistant Staphylococcus aureus strains.

The research results have been published in the journal Microbial Biotechnology and have been presented at several scientific forums: the 12th Molecular Microbiology Meeting, the 7th Congress of European Microbiologists (FEMS) and EUROBIOFILMS 2019.

To prepare his dissertation, Pedro Dorado received a grant from the National Research Personnel Training Program (FPI) in the 2015 call for applications, as well as funding from the Universidad Pública de Navarra for scientific and technical research projects.
 

Sonia Sáenz Lahoya, a predoctoral researcher at Navarrabiomed’s Microbial Pathogenesis Unit - IdiSNA, will defend her doctoral dissertation for the Universidad Pública de Navarra (UPNA) via videoconference at 10:30 a.m. on Thursday, December 17, in the center’s assembly hall. Only people with prior authorization are permitted to attend in person.

The dissertation, “Noncontiguous operons: a new strategy to coordinate gene expression in bacteria,” was prepared at Navarrabiomed under the supervision of Iñigo Lasa Uzcudun, director of the center and principal investigator in the Microbial Pathogenesis Unit.

In bacteria, genes that code for proteins involved in the same biological process are often grouped into operons, which are coordinately regulated transcription units in bacteria. The genes of an operon are transcribed into a single polycistronic mRNA molecule, which codes for more than one protein under the control of the same promoter. This organization provides an efficient mechanism for coordinating the expression of functionally related genes and is the basis for gene regulation in bacteria.

This dissertation demonstrates the existence of a higher level of organization in the structure of the operon, known as a noncontiguous operon. It consists of an operon that contains a gene or genes that are transcribed in the opposite direction to the rest of the operon. This new transcription architecture is exemplified by the menE-menC-MW1733-ytkD-MW1731 genes, which are involved in the synthesis of menaquinone (an antihemorrhagic vitamin) in Staphylococcus aureus.

The results indicate that the menE-menC-ytkD-MW1731 genes are transcribed as a transcription unit, while the MW1733 gene, located between menC and ytkD, is transcribed in the opposite direction. This genetic organization generates overlapping transcripts whose expression is regulated through ribonuclease III-mediated processing and a transcriptional interference mechanism.

In light of these results, the classical view of the structure of operons must be revised to take account of this new operon arrangement in which cotranscription and overlapping transcription combine to coordinate functionally related gene expression.

The conclusions of the project have been published in the journal PNAS (Proceedings of the National Academy of Sciences of the United States of America). 

To carry out this research, Sonia Sáenz received a Research Personnel Training grant from the Ministry of Science.
 

Miren Vallejo Ruiz, a predoctoral researcher in the Navarrabiomed Hematological Oncology Unit – Navarre Health Research Institute (IdiSNA), will defend her doctoral dissertation from the Universidad Pública de Navarra on Tuesday, 17 November at 11 a.m. The event will be held in the Navarrabiomed Assembly Hall. Due to current COVID-19 restrictions, attendance is limited, but a videoconference of the defense will be available.

The dissertation, “Evaluation of functional immune response developed against cytomegalovirus, Epstein-Barr virus and adenovirus and their regulatory elements in allogeneic hematopoietic stem cell transplantation recipients,” was developed at Navarrabiomed under the direction of Natalia Ramírez Huerto, Head of the Hematological Oncology Unit.

Research focused on describing the main biological and genetic variables that affect the development of a protective immune response to infections caused by cytomegalovirus (CMV), Epstein-Barr virus (VEB) or adenovirus (AdV) in patients who have received an allogeneic hematopoietic stem cell transplantation (allo-HSCT), i.e., those requiring the administration of healthy stem cells to increase bone marrow function.

One of the results of this study shows that the analysis of the functionality of the subpopulation of virus-specific T cells in patients who have received an allo-HSCT can be used to predict CMV infection in the post-transplantation period. T cells help destroy tumor cells and control immune responses.

With regard to the parameters that regulate the workings of this immune response, the study also used samples from healthy donors to show that gliotoxin (GT), the fungal toxin in Aspergillus fumigatus (AF), inhibits the function of subpopulations of T cells and natural killer (NK) cells, whose mission is to destroy infected cells and cancer cells, and to regulate immune responses.

In vitro observations also confirmed that the presence of GT in combination with the drugs ciclosporin A and methotrexate triggers a mechanism that impedes immune response. These drugs are used as a prophylactic against graft-versus-host disease (GvHD) in these patients. This experimental result was corroborated in patients after HSCT, when the presence of bis-methyl-gliotoxin (bmGT), the GT metabolite, in combination with the administration of cyclophosphamide, negatively modulated specific immune response against CMV/VEB/AdV.

Finally, the study confirmed that that the evaluation of certain polymorphisms in cytokine and chemokine genes and their receptors in patients and their respective donors can be used to predict the individual risk of developing CMV infection after HSCT. Analysis of these polymorphisms was used to generate an equation and a practical score for early identification of patients with a high risk of CMV infection after allo-HSCT.

These results were presented at three events: the International Conference of the European Society for Clinical Cell Analysis held in Valencia in September 2018, the 24th Congress of the European Hematology Association held in Amsterdam in June 2019, and the 61st National Conference of the Spanish Society of Hematology and Hemotherapy (SEHH/SETH) held in Valencia in October 2019. The research study was also on display in October 2020 at the 62nd edition of the SEHH/SETH conference. 

In order to prepare her dissertation, Miren Vallejo was a beneficiary of the Government of Navarre’s 2017-2019 Industrial Doctoral Students financial aid program, issued in 2016, for research and knowledge-sharing companies and organizations to hire doctoral students. While preparing her dissertation, Miren Vallejo also participated in an internship from June to December 2018 in the group “Genetic and clinical analysis of hematological neoplasms and stem cell transplantation” at Gregorio Marañón General University Hospital.
 

Marina Iridoy Zulet, a neurologist trained at the Hospital Complex of Navarre (CHN) and a predoctoral researcher in the Navarrabiomed associated research group Neuromuscular Disease and Motor Neuron Disease, will read her doctoral dissertation in the School of Health Sciences lecture hall at the Universidad Pública de Navarra (UPNA) at 12 noon on Thursday, 12 November. Marina Iridoy currently forms part of the neurology team at Zumarraga Hospital.

Her dissertation, “ProtALS Study: Proteomic analysis of postmortem tissue of subjects with amyotrophic lateral sclerosis. The search for biomarkers and therapeutic targets,” was developed at Navarrabiomed under the direction of Ivonne Jericó Pascual, a specialist doctor in the CHN Neurology Service and a Navarrabiomed associate researcher, and Joaquín Fernández Irigoyen, the coordinator of the Proteomics Platform and a researcher in the Navarrabiomed Clinical Neuroproteomics Unit – Navarre Health Research Institute (IdiSNA). Due to current COVID-19 restrictions, attendance is limited, but a videoconference of the defense will be available.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder. Diagnosed patients have a life expectancy of three to five years. Its prevalence in Navarre is 6.2 cases per 100,000 inhabitants per year. Unfortunately, no biomarkers of the disease have been identified to allow for early diagnosis. After the first symptoms appear, diagnosis can sometimes take up to 12 months. Treatments to effectively cure the disorder are also currently unavailable.

In her dissertation, Marina Iridoy performed exhaustive proteomic analysis of postmortem neurological tissue of people with ALS. The goal was to obtain a panel of possible biomarkers of the disorder that could then be analyzed in the blood serum of patients with a clinical diagnosis of ALS in order to validate them as possible biomarkers of the disease.

The study results were published for a meeting of the European project Network to Cure ALS (ENCALS) and in the journal International Journal of Molecular Sciences.

This project began in 2015 thanks to the Ice Bucket Challenge fundraising campaign led by the Association of Patients with Amyotrophic Lateral Sclerosis and Family Members in Navarre (ANELA) with the aim of increasing our knowledge of the disorder.

Navarrabiomed se suma un año más a las actividades de las Semanas de la Ciencia, la Tecnología y la Innovación de Navarra 2020, evento de divulgación científica que tendrá lugar entre el 9 y al 21 de noviembre de 2020.  Se celebrarán numerosas actividades para acercar la ciencia a la ciudadanía: conferencias, talleres, mesas redondas, puertas abiertas, espectáculos, entre otros. Debido a la situación actual de pandemia por la Covid-19, muchos de los eventos serán online y, los que son presenciales, se realizarán bajo las normas de seguridad establecidas para prevenir la infección del virus, como el aforo limitado y el uso de mascarilla.

En esta edición Navarrabiomed ha programado dos webinar para divulgar la actividad del centro de investigación biomédica:
 

• Miércoles, 18 de noviembre, 16:30 h. Investigación biomédica. Conoce en este webinar cuáles son los pasos necesarios para dedicarte a la investigación, una salida profesional apasionante y de máxima actualidad. Intervendrán Iñigo Lasa Uzcudun, Director de Navarrabiomed, María Apellániz Ruiz, Investigadora de la Unidad de Medicina Genómica de Navarrabiomed e Imanol Arozarena Martinicorena, Investigador Principal de la Unidad de Señalización en Cáncer de Navarrabiomed.
  
  Sesión online vía zoom exclusiva para alumnado de Bachillerato de Ciencias, FP o grados universitarios. Requiere inscripción previa desde la web de Navarrabiomed (hasta las 15:00 h. del miércoles, 18 de noviembre). Se enviará enlace directo e ID/contraseña al email facilitado.
   
• Jueves, 19 de noviembre, 18:30 h. Del ensayo clínico al medicamento que nos recetan. Conoce en esta sesión el proceso integral del desarrollo de un fármaco. Interviendrán Ruth García Rey,  Responsable Área Clínica de la Plataforma de Ensayos Clínicos de Navarrabiomed, Eva Zalba Garayoa, Responsable Área de Gestión de la Plataforma de Ensayos Clínicos de Navarrabiomed y Patricia Fanlo Mateo, Facultativa Especialista de Area del Servicio de Medicina Interna del Complejo Hospitalario de Navarra.
  
  Sesión online vía zoom para cualquier persona interesada. Requiere inscripción previa desde la web de Navarrabiomed (hasta las 15:00 h. del jueves, 19 de noviembre). Se enviará enlace directo e ID/contraseña al email facilitado.

• The work was carried out within the framework of ICTUSnet, a European project for interregional collaboration promoting innovation and improved healthcare for stroke patients.

María Herrera Isasi, a neurologist in the Stroke Unit at the Hospital Complex of Navarre (CHN) and the coordinator of the ICTUSnet project in Navarre (which is done at Navarrabiomed), and Silvia Astráin Mendoza, the project leader at the Brain Injury Association of Navarre (ADACEN), gave a press conference today at Navarrabiomed on the conclusions of a multidisciplinary study on sharing clinical decision-making in the healthcare process of stroke patients. This initiative was implemented within the framework of ICTUSnet, a European project for interregional collaboration for innovation and improved healthcare for stroke patients. The speakers were accompanied by Marta Ancín Pagoto, CHN Director of Healthcare Services.

The press conference was held today in commemoration of World Brain Injury Awareness Day and World Stroke Day, which is Thursday, October 29. Stroke is the primary cause of brain injury.

Consensus between professionals and patients

Sharing clinical decisions implies the use of a relationship model between healthcare professionals and patients throughout the diagnostic process and therapy. It also involves the need to keep patients informed during the different healthcare stages and empower them by giving them an active role to play. This kind of decision-making is in line with patient-centered medicine in its aim to provide more humane care. It also involves two-way communication rather than one-sided release of information, and it has been demonstrated that patients adhere better to the chosen procedure.

María Herrera explained what this model involves in healthcare practice. “As professionals, we’re aware that it’s our obligation to inform patients about the procedures available to prevent, diagnose and treat specific health problems, including the different options, their goals and possible consequences. And we do all this by using informed consent forms and providing information during interviews. But now we are going one step further. The idea is to ensure that decision-making includes the other side, namely, the life goals, values, priorities and needs specific to the patient, who, in this case, is a stroke patient or someone at risk of suffering from a stroke, as well as the patient’s family members or representatives, to reach a firm decision together that considers both sides with the active participation of the patient,” she said. She also highlighted the fact that this new model represents a change in the form of communication, which means that professionals will need training, as well as new tools to provide support for ICTs and audiovisual information, along with a commitment from the public authorities to promote this model with patient-centered work areas, as well as models of interdisciplinary action and teamwork.

From this global perspective, the study analyzed the current status of the model of sharing clinical decision-making in the stroke care process in the Navarre Health Service – Osasunbidea. The study involved organizing, in collaboration with ADACEN, four focus group meetings in February and March (prior to the pandemic) made up of representatives of all stakeholders involved: patients, family members, professionals in neurology, neurorehabilitation, primary care and social work, as well as management professionals from the Navarre Ministry of Health, among others.

Silvia Astráin was pleased with how the sessions went. She said, “We were able to provide a place for people to reflect on the topic, share experiences, point out uncovered needs and existing barriers, and identify the areas of healthcare that can be improved.” The ADACEN association, which helps people with acquired brain injury and their families, has been fighting to ensure patients receive the best care since it was founded in 1994. ADACEN officials are therefore pleased that time is being spent to listen to the opinions and needs of patients and their family members so that changes can be made to the process.

Marta Ancín stressed the importance of collaborative work between professionals to promote comprehensive patient care. She also brought up the commitment made by the Navarre Ministry of Health when it implemented its Humanization Strategy of the public health system in 2017. “Despite the delicate experience we are living through, these actions and projects should be maintained to make progress on and improve patients’ satisfaction with the treatment they receive,” Ancín said.

The press conference ended with some words from Iosune Etxebeste Arretxea, a stroke patient, and Pilar Seminario Alonso, a family member. Both participated in the focus groups and wanted to provide a face for all those people who live with the effects of a stroke or who are caregivers or companions.

Educational video and documents

Anyone interested in finding out more about this study on sharing clinical decision-making can consult the technical documentation on the conclusions, the video Working Together on Stroke Care Strategies, and the guidebook for patients and family members.
All these actions fall within the framework of the ICTUSnet Project, which forms part of the Interreg Sudoe Program, an initiative financed by the European Regional Development Fund (ERDF). The mission of ICTUSnet is to create a collaboration network of different Southern European regions made up of patients and professionals working in different stroke-related areas. At the same time, the project aims to create research infrastructure that draws on innovative data analysis technologies to improve comprehensive stroke care systems and reduce the impact of the disease on the population.

Information webinar on the occasion of World Stroke Day

The CHN Stroke Unit team invites all those interested to participate in the webinar “Stroke and COVID-19” on Thursday, October 29 at 4 p.m. Professionals from the CHN, primary care, ADACEN and the Ubarmin Clinic will participate by providing information on how COVID-19 has affected the process of stroke and acquired brain injury in Navarre. Information will also be presented on how healthcare and association resources have been adapted to continue providing care to patients at all stages (including primary care, preventive measures, hospital care, neurorehabilitation and social health resources).