IDIVAL Clinical and Molecular Microbiology group will participate in the Science Week, one of the most important scientific events of the year in Europe. On days 6, 9, and 16 of November, IDIVAL will be open to the Cantabrian high school students, to show their daily work in an attractive way, in which students can learn and participate in scientific workshops.

The workshops will be divided into two parts. In the first one, Dr. José Ramos Vivas will explain why there are bacteria resistant to antibiotics and how it has reached a situation in which this topic is a priority in research to safeguard human health.

Photo from IDIVAL Science Week 2016

On the second part of the workshop, attendees will be shown the laboratories of bacteria and human cells that the research group uses to study the mechanisms of infectious diseases.

Finally, there will be a brief description of how scientific research begins in the laboratory and ends up in hospitals and patients.

Sorafenib is the principal (and until recently the only) first-line systemic treatment for patients with advanced hepatocellular carcinoma (HCC). Despite having been shown to improve survival in 2 randomized clinical trials compared with placebo [Llovet JM et al. N Engl J Med. 2008; 359: 378-90 and Chen A-L et al. Lancet Oncol. 2009; 10: 25-34] its has been undervalued due to the absence of complete responses even though patients who develop early dermatologic reactions have shown very positive outcome. In particular, the complete radiological response has been described anecdotally.

The objective of the study was to know the complete radiological response rate of patients with HCC treated with sorafenib, as well as to analyze the characteristics of these patients, including the development of early dermatological adverse effects, which have been related to a better prognosis.

For this purpose, a retrospective multicenter study was carried out, selecting those patients with complete radiological response during treatment with sorafenib.

We reviewed 1,119 patients in 13 Spanish centers. Of these patients 12 (1.1%) achieved complete radiological response after starting with sorafenib. These patients (males 75%, median age 59.7 years, 83.4% Child-Pugh A, BCLC C 83.3%) had a median overall survival of 85.8 (95% CI 67.8-103.8). Nine of the 12 patients had elevated baseline AFP and in 8 of them it was normalized. Of the 12 patients, 7 stopped treatment with sorafenib after reaching a complete response, of which 5 presented recurrence.

Eleven (91.7%) of the 12 patients presented adverse dermatological effects in the first 60 days of treatment, a much higher proportion than that reported in previous studies in our environment (approximately 24% in the SHARP study [Llovet JM et al., N Engl J Med. 2008; 359: 378-90], 37% in the study by Reig et al [Reig M et al., J Hepatol 2014; 61: 318-324], approximately 26% according to data from the GIDEON study in Spain [Turnes J et al., Gastroenterol Hepatol, 2015; 38: 263-273]).

The conclusion of the study is that the complete response with sorafenib affects 1% of the patients and there seems to be an association with the occurrence of adverse dermatological effects. The mechanism by which adverse dermatological effects are associated with the radiological response and with a better prognosis is unknown, but it is speculated with a possible immunomodulatory / proinflammatory role induced by the drug. The appearance of this toxicity should be interpreted as a favorable prognostic marker and it is extremely important to optimize its management in order to try to maintain the treatment in these patients.

Reference: Study published in the journal Hepatology. Jordi Rimola, Álvaro Díaz-González, Anna Darnell, María Varela, Fernando Pons, Manuel Hernández-Guerra, Manuel Delgado, Javier Castroagudin, Ana Matilla, Bruno Sangro, Carlos Rodríguez de Lope, Margarita Sala, Carmen González, Carlos Huertas, Beatriz Mínguez, Carmen Ayuso, Jordi Bruix, María Reig.

Some 40 years since CT scans first revealed abnormalities in the brains of schizophrenia patients, we can now say, that in general (not all patients have) the disorder is a systemic disruption to the brain's entire communication system.

This week, the Nature journal Molecular Psychiatry published the largest analysis of “white matter” (fatty brain tissue enabling neurons to talk to each other) in mental health to date. “The integrity of this substance that allows normal mental functioning is altered,” “these abnormalities are focused on frontal and temporal lobes, giving rise to symptoms of this illness,” says Benedicto Crespo-Facorro.

Magnetic resonance imaging of 1,963 people with schizophrenia and 2,359 healthy controls from around the world were analyzed showing how the effect of schizophrenia on brain wiring is global. The areas where the differences between patients and healthy are more evident are the corpus callosum, which allows for communication between the brain hemispheres and in the frontal portion of the corona radiata, a key structure for information processing. This research reveals that we must study the effect of white matter globally and not focus the next research in a specific area.

This study has been carried out within the ENIGMA consortium and is the first that this consortium carries out in order to study cerebral white matter in schizophrenia. “These new and interesting findings demonstrate the existence of alterations in the normal” brain wiring “in a number of patients with schizophrenia, and represents a first step in new lines of biological investigation of the disease.”

The big data project was integrated from 29 different international studies, including researchers from the Psychiatry group of the University of Cantabria-IDIVAL-CIBERSAM, led by Dr. Benedicto Crespo-Facorro and the group of Dr. Celso Arango of the University Hospital Gregorio Marañón- Universidad Complutense-CIBERSAM. “In the last years the cerebral neuroimaging studies are contributing relevant evidences in the knowledge of the biological bases cerebral of the mental illnesses”.

This IDIVAL research group had already published two papers using this technique led by Dras. Pérez-Iglesias and Tordesillas-Gutiérrez in which similar effects were shown in a sample of first episodes of psychosis and its relation with effects on cognitive processes, studies published in the prestigious journals Neuroimage and American Journal of Psychiatry.

Guillain-Barré syndrome (GBS) is an immune-mediated cause of acute neuromuscular paralysis. During the last three decades, the Neurology Service (University Hospital Marques de Valdecilla), collaborating with the Clinical Neurophysiology, Radiology, Pathological Anatomy, and the Department of Anatomy and Cell Biology of the University of Cantabria (UC) have done epidemiological, clinical-pathological and nerve ultrasound investigations in GBS.

There had been established that the incidence rate of GBS in Cantabria is 0.95 cases per 100,000 population, and in early stages (first 10 days of clinical course) the inflammatory pathology mainly falls on proximal nerve trunks accentuating in the spinal root transit to the spinal nerve, which correlates well with the predominant alterations of the C5-C7 spinal cord in the ultrasonographic examination. Autopsy studies of early GBS are scanty; Haymaker and Kernohan [Medicine (Baltimore) 1949; 28: 59-141] had described that the initial lesions, consisting of endoneurial oedema, predominate where the spinal roots are joined to form the spinal nerves. This notion had gone largely unnoticed in the neurological literature.

Revising the literature, starting from the original descriptions of the GBS, we have established that in the first days of the clinical course the endoneural inflammatory edema of the spinal nerves is the most relevant pathogenic alteration, which precedes both the demyelination of the nerve fibers as wallerian degeneration, either primary or secondary (Berciano, Journal of the Neurological Sciences 2017, 382: 1-9). Thus, the lesion topography proposed by Haymaker and Kernohan is corroborated. Our studies indicate that early inflammation in epi-perineurial nerve trunks, such as spinal nerves, leads to increased endoneural pressure, a potential cause of compromised transperineural blood flow, which may result in endoneural ischemia with the corresponding failure of the conduction of the nerve impulse. These findings have the following implications: i) proximal conduction block (at the level of the spinal nerves) explains the mechanism of ascending paralysis in cases where conventional neurophysiological studies are normal or insufficiently informative; ii / for early diagnosis, neurophysiological and imaging techniques are needed to detect lesions in the proximal nerve trunks; iii / need to include the spinal nerves in the protocol of autopsy of early fatal cases, in order to detect pathogenic lesions; and iv) the urgent need for new therapeutic approaches to curb the impact of endoneural inflammatory edema on nerve fibers, the consequence of which may be the axonal degeneration responsible for irreversible residual paralysis.

Reference: Berciano J. Spinal nerve involvement in early Guillain-Barré syndrome: The Haymaker and Kernohan's legacy. J Neurol Sci 2017; 382: 1-9.

As part of the Valdecilla Biosanitary Program, after its success in 2016, IDIVAL called INN-VAL 2017 (VALdecilla INNovación Projects). The aim of these grants is to promote innovation through financing a partial or complete project that facilitate the collaboration of the health sector, the university environment and companies.

According to the basis of the call, projects, which can be developed in collaboration with companies and other centers, have a personal researcher with employment relationship with IDIVAL, the Cantabrian Health Service, or the University of Cantabria as a teacher linked to care activity, or personnel from a IDIVAL research group.

According to the terms of the call published on the IDIVAL website, once the projects admitted to the process have been evaluated, the following projects are granted financing for execution within a period of 2 years:

Its execution is subject to the IDIVAL’s project management instructions. 

More information on: IDIVAL funding

The next 24^th of October at 4:00 p.m., the Cantabrian Minister of Health will present the conference “Human factor: A new approach to organizational health”.

At this session will attend world experts in human factor from Medstar National Innovation Center (Washington) and there will be presented new tools for evaluating health technologies; redesigning processes that they are having a great impact in other countries; and actions that are already being developed in the Public Health System of Cantabria based on the science of human factor.

The conference is open to companies and all professionals in the field of care staff and management and it will be a first approximation to this area which is considered of strategic interest as a tool for organizational innovation in the Public Health System of Cantabria.

COST Actions are bottom-up science and technology networks, open to researchers and stakeholders with a duration of four years. They are active through a range of networking tools, such as workshops, conferences, training schools, short-term scientific missions (STSMs), and dissemination activities. COST does not fund research itself.

COST prides in its support for high-risk, innovative and emerging research themes. However, COST does not set any research priorities.

We invite participants to submit proposals for COST Actions contributing to the scientific, technological, economic, cultural or societal knowledge advancement and development of Europe. Multi- and interdisciplinary proposals are encouraged. 

The open call Action Proposal Submission, Evaluation, Selection and Approval (SESA) procedure  is fully science and technology-driven and will ensure a simple, transparent and competitive proposal evaluation and selection process, reflecting the bottom-up, open and inclusive principles of COST. 

The minimum number of countries included in the network has increased to seven COST Full or Cooperating Members. Out of the seven, a minimum of three must be Inclusiveness Target Countries. 

Participants will also need to include the updated technical annex, which should not exceed 15 pages. Results will be communicated in November 2018.

For any questions related to the open call, please contact innovacion4@idival.org 

The presentation of the results of the INNyCRON Call will take place on 31 October at 12:30p.m. in the Assembly Hall at Tower B of the Marqués de Valdecilla University Hospital. At this presentation will attend the Minister of Health and the Manager of the Cantabrian Health Service, and next, projects will be presented. The end of the day is scheduled at 2.30pm. 

The INNyCRON program, convened by IDIVAL thanks to the ad hoc financing of the Oximesa company, has as a specific and priority objective to facilitate and promote the emergence of innovation through projects that arise from professionals, developed within the scope of the Chronicity Strategy in the biosanitary environment of Cantabria.
On October 31 there will be a presentation of the projects and the results of the call.

Program of the Day

1.- Presentation of the Day

María Luisa del Real. Consejera de Sanidad.

Julián Pérez Gil. Gerente SCS.

2.- Exhibition of projects (10 minutes per project):

– Eloy Manuel Rodríguez Rodríguez. Proyecto piloto para el desarrollo de una plataforma web de teleasistencia al paciente con  deterioro cognitivo.

– Montserrat Rivero Tirado. Proyecto de Telemedicina para la asistencia de pacientes con Enfermedad Inflamatoria Intestinal:  Creación y evaluación de una plataforma web para personal sanitario y pacientes.

– Isabel Pérez Loza. App MeCuidoPostIAM.

– Gonzalo Martínez De Las Cuevas. Ruta asistencial para pacientes crónicos complejos con insuficiencia cardiaca.

– Carlos Fernández Viadero. Valoración de cronicidad, sarcopenia y fragilidad, como instrumento para la prevención del deterioro  de la capacidad intrínseca en ancianos. Un estudio en el Valle del Nansa. 

– María Consuelo Fernández Diego. Las enfermedades crónicas en el contexto escolar. Percepción de los padres y profesores de  educación primaria.

– Javier Crespo García. Educación y seguimiento estrecho de pacientes con cirrosis hepática descompensada. Mejoría en calidad  de vida, reingresos y mortalidad.

– Ana Aguilera Zubizarreta. Hospitalización domiciliaria en el paciente crónico.

3.- Closing of the Day. 

Next October 25^th at 8:15am Belén Bornstein, Deputy Director of Evaluation and Promotion of Research at the Institute of Health Carlos III, will give an extraordinary session entitled “Present and future of AES in the context of Translational Research in Biomedicine”.

The conference will take place in the Assembly Hall of Tower B at Marqués de Valdecilla University Hospital and at the end there will a cafe where the Assistant Director will talk to all the interested assistants. 

Belén Bornstein (Madrid, 1959) gained a degree in Medicine and Surgery from the Universidad Complutense de Madrid in 1983 and a PhD from the same University in 1990.

Her specialty in Clinical Biochemistry was in the Hospital 12 de Octubre and her work as a specialist was developed in the Severo Ochoa Hospital in Leganés and Puerta de Hierro University Hospital in Madrid, in which she joined in 2005. As a complement to her training she did two stays in international centers as the Carlo Besta Institute in Milan and Columbia University in New York.

She has a long experience in the study of mitochondrial diseases, which began in 1990 with the biochemical study of mitochondrial myopathies in the laboratory of metabolic diseases of the Hospital 12 de Octubre in Madrid.

Scientific evaluation has been another of her professional activities. She was a member of the Technical Evaluation Committee of the human resources programs and of the Technical Commission for Infrastructure Evaluation of the Health Research Fund, evaluator of research projects of the Health Research Fund and at the National Evaluation and Prospective Agency (ANEP).

It is part of the mitochondrial pathology program of the CIBER of rare diseases (CIBERER) since its creation. In 2008 she was appointed head of the molecular genetics unit at Madrid's Puerta de Hierro University Hospital. The genetic study of familial heart disease is one of its primordial areas. She collaborated in the accreditation, which was obtained in 2014, of the reference unit (CESUR) of the Family Cardiopathies in the Cardiology Service at the same hospital.

In 2010 she assumed the leadership of the Group of Mitochondria and Cardiopathies at the Research Institute of Puerta de Hierro University Hospital (Idiphim); in January of 2015 she joined ISCIII as Director of Institutional Relations and later as Deputy Director of Evaluation and Promotion of Research, which she currently holds.

25^th of September 2017, resolution from the Vice-Rector of Research and Knowledge Transfer (UC) and IDIVAL Management Director, which makes public the provisional list of applications admitted, excluded and pending of rectification, to the call for predoctoral contracts in the area of biomedicine, biotechnology and health sciences, published by Resolution of June 12, 2017.

Resolution and annexes: (download pdf)

Annex I: admitted applications

Annex II: excluded and pending of rectification applications.

The term of correction is from the 28^th  September to the 11^th of October 2017.