The Department of Clinical Chemistry and
Pharmacology (KLINBIOCHEM) will act as one of three pilot sites. The
main task of the pilot sites is to perform the evaluation of the
proposed systems’ usability and clinical value. A specialist in internal
medicine, Markus Look, who already gained experience in projects
directed at personalized medicine including working with preventive gene
polymorphism analyses and analysis of biomarker, will join the
department for the study.
According to the title of the market
validation study - “An integrated high secure cross border platform for
preventative healthcare incorporating genetic and lifestyle analysis” –
the main objective of the survey will be selection of patients who
display early risk factors for cardiovascular disease, e.g. high blood
pressure, elevated LDL-cholesterol and/or low HDL-cholesterol, elevation
of homocysteine, increased inflammatory and coagulation biomarkers, such
as interleukin-6 and hs-CRP, fibrinogen, who are accessible to life
style adjustments (exercise, diet, cessation of smoking etc.) and
The pilot site KLINBIOCHEM selected the
criterion of obesity for the testing of the consortium’s service.
Therefore, a case-control study comparing two groups, non-obese vs.
obese individuals with respect to their genetic variation, biomarker and
life-style habits, will be performed.
Intended final outcome of the
EUROGENE project as a whole is improvement of an individual’s and/or
physician’s decision making process regarding methods of intervention
through diet, exercise, medication and also by means of early
identification of risk constellations on a genetic level. Since
integration of genetic data into the physician’s or the individual’s
decision making process is a novel issue, the presumptions which will be
made on the basis of genomic information have yet to be fully validated
in the ongoing worldwide scientific process.
communicated to the patient, knowledge of putative genetic
risk-constellations may eventually motivate the patient to introduce
significant life-style changes, compared to what is presently achieved
in disease prevention without genetic information.
The assets of the
Department of Clinical Chemistry and Pharmacology regarding the project
Close contact to all medical disciplines present on the
university campus and in the region, in order to recruit study
participants and to gather information regarding interests of potential
Optimum facilities for storage of blood samples for
re-analysis and assessment of a wide range of biomarker, such as
HDL/LDL-cholesterol homocysteine, B-vitamins, insulin, interleukin 6, hs-CRP,
fibrinogen and others. Biomarker levels will be evaluated along with the
genetic variants and life style patterns of the participants of the
As a governmental institution, the department is highly
trustworthy with respect to acceptance of genetic testing by the general
public. However, an ethics committee’s approval, which is obligatory,
will be applied for and the department will not appear as a commercial
If the survey proves successful in testing the technical
capabilities of the system, which is a priority in this phase of the
project, further contacts to expand the system could be made with other
stakeholders (practitioners and clinics) who are treating and counseling
the relevant target groups.
This, however, will also depend on the
acceptance of the “tool” of preventive gene analysis by these
stakeholders, the society as a whole and most importantly on the pending
legislation processes in Germany.
The BHCA is responsible for the public
health care services in the eastern half of the Spanish province of
Huesca. The BHCA covers all assistance levels: primary, specialized,
socio sanitary and mental. The BHCA provides health care services to
100.000 inhabitants within a geographic area of 7.500 square kilometres.
Population density is very low, being very dispersed though many
villages sparsely populated. The orography of the zone very hard, does
not help in order to have good communications; especially in the north
part where the Pyrenees Mountains have their main peaks.
The BHCA is
divided in fifteen geographic areas called “zonas de salud” (literally
“health care zones”). In each of such “health care zones”, there is a
Health Care Center that provides ongoing primary health care services to
the citizens. Second level (specialized) health care services are
provided by the General Hospital, placed in the geographical centre of
the geographic area, Barbastro. This Hospital has two branches: one
located in Monzón and a second one in Fraga, both covering certain
specialities. Besides there is a socio sanitary centre located in the
far South of the territory.
The BHCA heads on towards a scenario
where an outstanding health care service is provided through the optimum
management of public resources allocated whilst reaching a high level of
customer satisfaction, fully backed by the citizens. Besides, all and
every professionals working for the BHCA are motivated and highly
involved in achieving this objective.
The objective is to provide an
“end to end” health care service to the citizens and residents within
the BHCA geographical area, by ensuring their easy and quick access to
the service, understood as: promotion of healthy ways of life;
prevention and protection against physical, environmental and biologic
factors; provision of any care required in an illness situation; whilst
keeping the highest degree of autonomy and insertion of patients in
their environment and in the society in order to meet all his/her needs
and expectations in terms of personal health.
The hospital has 160
beds available in the hospitalization area. Surgical area has 5
operating theatres. Ambulatory care is provide through offices in the
hospital itself as well as in two specialized delegations, located 17
and 75 km away from the main site, respectively.
services available at the hospital are:
Cardiology, Gastroenterology, Geriatrics, Pulmonary Disease, Neurology,
Medical Oncology, Paediatric, Rheumatology.
In the primary health
care area there are 14 health care centres and 136 offices.
health care sector has made a revolution in the way of managing the gap
between the two levels of health care assistance, primary assistance and
specialized assistance through the deployment of two strategic project,
which the Aragon’s Health Service (Servicio Aragonés de la Salud) is now
replicating through the rest of the organization.
The first project
consisted on the development of a powerful intranet for the sanitary
sector allowing the integration of the different IT systems available in
the two levels of health care assistance (primary and specialized),
which has been the starting point for the existence of the single record
for patient shared among primary, specialized and sociosanitary
attention. This approach has improved the availability and accessibility
of the clinic data and improving consequently the assistance quality.
Also, a telemedicine system has been deployed allowing the daily contact
and the sharing of knowledge among the different professionals in the
health care area (practitioners, specialist, nurses, etc.)
Our geographical area has traditionally depended on the
primary economic sector. During centuries, basic food has been based in
the kitchen garden, the farmyard, the olive oil and the wine, elements
that have played a key role in our population diet; what today is known
as Mediterranean diet. In this geographic area a big percentage of the
population is elder people, being the average age higher than for the
total of Aragon or Spain.
The dietetic advice oriented to maintain
the health and prevent the nutritional shortages, as well as the
degenerative sickness, are currently a frequent reason for a medical
consultancy. Also, some patients need a therapeutic diet as a part of
the treatment issued to attack their sickness.
The IT systems
integration, a good coordination among the different levels of
assistance and the high level of usage of the new technologies in the
BHCA are the key reasons for it to become an appropriate scenario for
the development of new health care programs developed by
Considering all these peculiarities and
within the program of assistance to elder people we are going to focus
our attention on their diet, trying to postpone the ageing process and
improving his/her quality of life, whether at the physic, psychological
or social level.
In order to get the maximum benefit from this
program, it would be very convenient to have available some software
tools with and inference machine tools that could provide dietetic
consultancy based on the constitutional and environmental information
provided by the patient.
The program is leaded by a
multidisciplinary team compound by general practitioner, a health
technician, a geriatrician, community nurses, a specialist in
biostatistics and the adequate admin support.
In order to achieve
the maximum from the proposed program, the initial scope will be
targeted in two different “zonas de salud” (health care zones): one
located in an urban area and another one belonging to the rural world