Legaz Pérez, Isabel

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Legaz Pérez, Isabel

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Legaz Pérez, Isabel

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Universidad de Murcia. Departamento de Ciencias Sociosanitarias

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Open Access
Use of mobile devices in medical education
(South Florida Publishing, 2021-05-17) Morales, Raquel; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Background: The evaluation in real-time allows the teacher to improve the deficiencies and propose immediate improvement actions that allow the student's correct acquisition of knowledge. Purpose: The objective was to implement in university students conduct real-time theoretical questionnaires in the classroom using mobile devices with real-time resolution and a later critical analysis of the results to improve the evaluation and learning process. Sample: A total of 300 university students belonging to a Medicine degree were analyzed in this study. All students have participated in this study voluntarily. Design and methods: A real-time questionnaire about Legal Medicine was conducted in the classroom using an online platform (“Live Interactive Audience Participation | Poll Everywhere” 2019). The students responded using Twitter. The students' different answers to the questionnaire's questions are visualized in real-time in the teaching classroom. A questionnaire with 13 items was developed to assess the students' opinions regarding this evaluation tool's use and capabilities. Results: Our results show that 86.5% of students considered and were very useful in using this teaching resource, which increased students' interest in the subject taught (75.3%). The use of real-time questionnaires in class showed a high degree of acceptance (77.4%) in the group of delighted students and only 37% in the group of students not very satisfied with the experience (P <0.001). A 43.8% of the student considered that the use of digital evaluation should increase in the classroom. Conclusions: This digital evaluation tool is an appropriate didactic resource to develop in the classroom since it increases student motivation and promotes the students' natural and active participation.
Open Access
Computational prediction of biomarkers, pathways, and new target drugs in the pathogenesis of immune-based diseases regarding kidney transplantation rejection
(Frontiers Media, 2021-12-15) Alfaro, Rafael; Martínez Banaclocha, Helios; Llorente, Santiago; Jiménez Coll, Víctor; Galián, José Antonio; Botella, Carmen; Moya Quiles, María Rosa; Parrado, Antonio; Muro Pérez, Manuel; Minguela, Alfredo; Muro, Manuel; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Background: The diagnosis of graft rejection in kidney transplantation (KT) patients is made by evaluating the histological characteristics of biopsy samples. The evolution of omics sciences and bioinformatics techniques has contributed to the advancement in searching and predicting biomarkers, pathways, and new target drugs that allow a more precise and less invasive diagnosis. The aim was to search for differentially expressed genes (DEGs) in patients with/without antibody-mediated rejection (AMR) and find essential cells involved in AMR, new target drugs, protein-protein interactions (PPI), and know their functional and biological analysis. Material and Methods: Four GEO databases of kidney biopsies of kidney transplantation with/without AMR were analyzed. The infiltrating leukocyte populations in the graft, new target drugs, protein-protein interactions (PPI), functional and biological analysis were studied by different bioinformatics tools. Results: Our results show DEGs and the infiltrating leukocyte populations in the graft. There is an increase in the expression of genes related to different stages of the activation of the immune system, antigenic presentation such as antibody-mediated cytotoxicity, or leukocyte migration during AMR. The importance of the IRF/STAT1 pathways of response to IFN in controlling the expression of genes related to humoral rejection. The genes of this biological pathway were postulated as potential therapeutic targets and biomarkers of AMR. These biological processes correlated showed the infiltration of NK cells and monocytes towards the allograft. Besides the increase in dendritic cell maturation, it plays a central role in mediating the damage suffered by the graft during AMR. Computational approaches to the search for new therapeutic uses of approved target drugs also showed that imatinib might theoretically be helpful in KT for the prevention and/or treatment of AMR. Conclusion: Our results suggest the importance of the IRF/STAT1 pathways in humoral kidney rejection. NK cells and monocytes in graft damage have an essential role during rejection, and imatinib improves KT outcomes. Our results will have to be validated for the potential use of overexpressed genes as rejection biomarkers that can be used as diagnostic and prognostic markers and as therapeutic targets to avoid graft rejection in patients undergoing kidney transplantation.
Open Access
Optimizing strategies to reduce alcohol consumption and relapses, improving abstinence in liver transplant recipients
(AME Publishing, 2022) Muro, Manuel; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Open Access
Patient sex in the setting of liver transplant in alcoholic liver disease
(Baskent University, 2019-06) Navarro Noguera, Elena; Bolarín, Jose Miguel; Campillo, Jose Antonio; Moya, Rosa; Miras, Manuel; Minguela, Alfredo; Álvarez López, María Rocio; Muro, Manuel; Legaz Pérez, Isabel; Luna Maldonado, Aurelio; Ciencias Sociosanitarias
Objectives: The aim of this study was to analyze alcoholic cirrhosis in women who were to undergo liver transplant, including their biochemical and clinical characteristics, main complications, survival rates, and main causes of death compared with men with alcoholic cirrhosis. Materials and Methods: Our study included 400 patients with alcoholic cirrhosis, which we divided according to sex and viral infections. Biochemical parameters and the presence and degree of ascites and encephalopathy, liver function status, and liver rejection and survivalrates were analyzed from 1 to 10 years and the main cause of death at 10 years. Results: Patients with nonviral alcoholic cirrhosis and liver transplant had significantly better survival rates (84.1%) at 1 year versus those with viral alcoholic cirrhosis (74.5%; P = .036). Men with nonviral alcoholic cirrhosis (14%) and women with hepatitis C virus (29%) had the lowest short-term survival rates. In long-term survival analysis, the lowest rate was observed in women with nonviral alcoholic cirrhosis (26.1%), and the highest rate was observed in women with hepatitis C virus (42.9%). Liver graft failure was one of the main causes of death in male patients (19.5%). Conclusions: Women with alcoholic cirrhosis showed a higher rate of ascites and encephalopathy but lower liver graft rejection than men with alcoholic cirrhosis. Survival rates were similar between men and women, although slightly lowerin women who had hepatitis C virus.
Open Access
Is the development of ascites in alcoholic liver patients influenced by specific KIR/HLA Gene profiles?
(MDPI, 2023-08-28) Morales, Raquel; Bolarín, José Miguel; Collados Ros, Aurelia; Pons, José Antonio; Muro, Manuel; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Decompensated cirrhosis is the most common cause of ascites due to hemodynamic and renal alteration by continuous fluid leakage from the hepatic sinusoids and splanchnic capillaries into the interstitial space. Then, fluid leakage exceeds lymphatic return, leading to progressive fluid accumulation directly into the peritoneal cavity. Alcohol consumption is one of the main risks of developing alcoholic cirrhosis (AC), but not all AC patients develop ascites. Avoiding the development of ascites is crucial, given that it deteriorates prognosis and increases the patient mortality patient. The innate immune system plays a crucial role in cirrhosis through natural killer cells, which are abundant in the liver. The aim of this study was to analyze the KIR/HLA-C genetic profile in AC patients with and without ascites to understand this pathology and find predictive clinical susceptibility biomarkers that can help to establish risks and prevent the development of ascites in AC patients. A total of 281 AC patients with and without ascites were analyzed and compared with 319 healthy controls. Genomic DNA was extracted from peripheral blood in all groups. A PCR-SSO assay was performed for KIR/HLA genotyping analysis. A total of 16 activating and inhibitor KIR genes and their corresponding known ligands, epitopes of HLA-C, and their genotypes were analyzed. According to our analysis, C1 epitopes were statistically significantly decreased in AC patients with and without ascites. When comparing AC patients with ascites and healthy controls, a significant decrease in C1 epitope frequency was also observed. A statistically significant decrease was also found when comparing the C1C2 genotype in AC patients without ascites with controls. In conclusion, the absence of KIR2DL2 and KIR3DL1 genes may be a predisposing factor for the development of ascites in AC patients. The KIR2DS2/KIR2DL2 may could be involved in grade I ascites development, and the presence of the C1+ epitope and the homozygous C2C2 genotype may be protective genetic factors against ascites development in AC patients.
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Diagnosis of vitality in skin wounds in the ligature marks resulting from suicide hanging
(Lippincott, Williams & Wilkins, 2017-09) Giménez, M.; Martínez Díaz, F.; Nuno Vieira, D.; Falcón Romero, María; Legaz Pérez, Isabel; Luna Maldonado, Aurelio; Osuna Carrillo-Albornoz, Eduardo Javier; Pérez Cárceles, María Dolores; Ciencias Sociosanitarias
Ascertaining the vital origin of skin wounds is one of the most challenging problems in forensic pathology. The forensic literature describes biomarkers and methods for differentiating vital and postmortem wounds, although no clear conclusions have been reached. The aim of this study was to characterize human vital wounds by analyzing the concentrations of metallic ions and the expression of P-selectin and cathepsin D in skin wounds in the ligature marks in a cohort of suicidal hangings for which vitality was previously demonstrated. A total of 71 skin wounds were analyzed within a postmortem interval of 19 to 36 hours. The concentration of Fe, Zn, Mg, and Ca and the expression of P-selectin and cathepsin D were analyzed together and separately. The majority of autopsied suicidal hangings were men (86%) with complete hanging mode (60.7%) in which there was a high frequency of subcutaneous injuries (78.3%). High concentrations of Ca and Mg compared with Fe and Zn were found. Ca and Zn concentrations decreased, and Fe concentration increased with the seriousness of the injury. A high percentage of moderately negative expression of both proteins was correlated with subcutaneous injury and low or medium concentrations of Fe. In conclusion, the joint study of metallic ions and proteins allows to characterize and to differentiate an injured vital wound of noninjured skin, especially when the damage in the tissue affects to the majority of the structures of the skin, but these results will need to be complemented with other biomarkers in time-controlled samples to further help in the differentiation of vital and postmortem wounds.
Open Access
Lipidomes in cadaveric decomposition and determination of the postmortem interval: a systematic review
(MDPI, 2024-01-12) Caballero Moreno, Leticia; Legaz Pérez, Isabel; Luna Maldonado, Aurelio; Ciencias Sociosanitarias
Lipids are a large group of natural compounds, together with proteins and carbohydrates, and are essential for various processes in the body. After death, the organism’s tissues undergo a series of reactions that generate changes in some molecules, including lipids. This means that determining the lipid change profile can be beneficial in estimating the postmortem interval (PMI). These changes can also help determine burial sites and advance the localization of graves. The aim was to explore and analyze the decomposition process of corpses, focusing on the transformation of lipids, especially triglycerides (TGs) and fatty acids (FAs), and the possible application of these compounds as markers to estimate PMI and detect burial sites. A systematic review of 24 scientific articles from the last 23 years (2000–2023) was conducted. The results show that membrane glycerophospholipids (such as phosphatidylcholine and phosphatidylglycerol, among others) are the most studied, and the most promising results are obtained, with decreasing patterns as PMI varies. Fatty acids (FAs) are also identified as potential biomarkers owing to the variations in their postmortem concentration. An increase in saturated fatty acids (SFAs), such as stearic acid and palmitic acid, and a decrease in unsaturated fatty acids (UFAs), such as oleic acid and linoleic acid, were observed. The importance of intrinsic and extrinsic factors in decomposition is also observed. Finally, as for the burial sites, the presence of fatty acids and some sterols in burial areas of animal and human remains can be verified. In conclusion, glycerophospholipids and fatty acids are good markers for estimating PMI. It has been observed that there are still no equations for estimating the PMI that can be applied to forensic practice, as intrinsic and extrinsic factors are seen to play a vital role in the decomposition process. As for determining burial sites, the importance of soil and textile samples has been demonstrated, showing a direct relationship between saturated fatty acids, hydroxy fatty acids, and some sterols with decomposing remains.
Open Access
Occult bloodstains detection in crime scene analysis
(Elsevier, 2021-09-25) Indalecio Céspedes, Carlos Rafael; Sánchez Rodríguez, María Faustina; Hernández Romero, Diana; Legaz Pérez, Isabel; Osuna Carrillo-Albornoz, Eduardo Javier; Ciencias Sociosanitarias
Blood detection in forensic investigation is the milestone in crime scene analysis. Locating bloodstains on dark clothing are often difficult and it is well known the discrepancy about selection of the most suitable method to locate and identify blood stains, depending on the presence of different contaminants and the occurrence of false positives or negatives of human’s blood. The main purpose of this paper was to compare different orientation tests for blood detection on different materials, presenting with contaminated samples and treatments. Human blood was tested in car mat, dark tiles, unlacquered wood surface and sneakers with recent and old stains. Samples were prepared with blood, paint, bleach, dish soap multi-use cleaner, juice, fruit and milk using different combinations and protocols. In the case of forensic lights, and depending on the wavelength and filter used, latent stains were not detected and some false negatives and false positives appeared in different contaminants and treatments. In addition, bleach resulted the main contaminant, altering most tests. In conclusion, our results confirmed that luminol is the most effective test for detecting fresh and latent blood stains, because no type of contamination interfered on its reliability.
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Dynamic patterns of colocalization of calbindin, parvalbumin and GABA in subpopulations of mouse basolateral amygdalar cells during development
(Elsevier, 2008-01) Dávila, José Carlos; Olmos, Luis; Medina, Loreta; Guirado, Salvador; Real, Mª Angeles; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Calbindin cells represent a major interneuron subtype of the cortical/pallial regions, such as the basolateral amygdala, which are often analyzed in studies of tangential migration of interneurons from the subpallial ganglionic eminences to the pallium/cortex. However, previous evidence suggests that during development the calbindin cells may include more than one of the interneuron subtypes found in the adult pallium/cortex. Furthermore, in the adult basolateral amygdala, calbindin cells include a subpopulation of non-GABAergic (non-interneuron) cells. To better characterize these cells throughout development, in the present study we investigated the colocalization of calbindin, parvalbumin and GABA in cells of the mouse basolateral amygdala during late embryonic (E16.5) and several postnatal ages from birth until 4 weeks after birth (P0, P10 and P28). Our results indicate that CB, PV and GABA show a dynamic pattern of colocalization in cells of the mouse basolateral amygdalar nucleus throughout development. From E16.5 through P28, the majority of CB+ neurons and virtually all PV+ neurons are GABAergic. However, after P10, the percentage of GABAergic CB+ cells decline from 96% to 70%. Furthermore, while only 9% of CB+ neurons are PV+ at P10, this percentage raises to 42% at P28. At all postnatal ages studied, the majority of the PV+ cells are CB+, suggesting that PV+ interneurons develop postnatally mainly as a subpopulation within the CB+ cells of the basolateral amygdalar nucleus. These results are important for interpreting data from interneuron migration.
Open Access
Codon pattern and compositional constraints determination of genes associated with chronic periodontitis
(MDPI, 2022-10-24) Khandia, Rekha; Pandey, Megha; Vladimirovich Rzhepakovsky, Igor; Ali Khan, Azmat; Legaz Pérez, Isabel; Ciencias Sociosanitarias
Genome-wide association studies showed the relationship of NIN, ABHD12B, WHAMM, AP3B2, and SIGLEC5 with chronic periodontitis. The study’s objective was to investigate different molecular patterns and evolutionary forces acting on the mentioned genes. The investigation of molecular patterns encompasses the study of compositional parameters, expression profile, physical properties of genes, codon preferences, degree of codon bias, determination of the most influential codons, and assessment of actions of evolutionary forces, such as mutations and natural selection. The overall compositional analysis revealed the dominance of A and G nucleotides compared to T and C. A relatively low codon usage bias is observed. The CTG codon is the most overused codon, followed by TCC. The genes, AP3B2 and SIGLEC5, preferred GC-ending codons, while NIN, ABHD12B, and WHAMM preferred AT-ending codons. The presence of directional mutational force and natural selection was found to operate codon usage in genes envisaged, and selective forces were dominant over mutational forces. Apart from mutation and selection forces, compositional constraints also played imperative roles. The study enriched our knowledge of specific molecular patterns associated with the set of genes significantly associated with chronic periodontitis. Further studies are warranted to identify more genetic signatures associated with the disease.