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Investigation
Development of new diagnostic methods for invasive fungal infection
Research Lines
Content with Investigacion .
El diagnóstico de la infección fúngica invasora (IFI) es complicado y con frecuencia se retrasa ya que en muchas ocasiones a la falta de sospecha clínica se le suma la falta de herramientas diagnósticas eficaces. Esta línea de investigación se inició en el año 2003, primero liderada por el Dr. Manuel Cuenca-Estrella y posteriormente por la Dra. María José Buitrago con el objetivo general de desarrollar nuevas herramientas, basadas en la PCR en tiempo Real, para un diagnóstico rápido de IFI. Los objetivos concretos que se han ido alcanzando a lo largo de estos años han sido los siguientes:
Detección precoz de hongos causantes de infecciones fúngicas oportunistas más frecuentes en pacientes inmunodeprimidos (Aspergilosis y Candidiasis invasoras)
Se han desarrollado y validado técnicas de PCR en tiempo Real en formato multiplex para el cribado de pacientes en riesgo de padecer estas infecciones, así como para el diagnóstico en pacientes con sospecha.
Detección de IFIs causadas por hongos emergentes (Escedosporiosis, Fusariosis etc...)
El aumento de especies raras o poco frecuentes causantes de IFI hizo necesario el desarrollo de técnicas para su detección
Detección “panfúngica”
Para aquellos casos en los que no exista evidencia clara del hongo causante de la infección se han desarrollado técnicas basadas en PCR en tiempo Real.
Mejora del diagnóstico y la identificación de los hongos causantes de micosis importadas (micosis endémicas)
Debido al aumento de la inmigración y los viajes a lugares exóticos en los últimos años se ha producido un incremento de las micosis importadas en España, en concreto de aquellas causadas por hongos endémicos de determinadas regiones, los cuales son además patógenos primarios. Este objetivo es relevante en el contexto de una región no-endémica ya que existe falta de experiencia en el manejo de estas infecciones y las técnicas diagnósticas disponibles son muy escasas. A lo largo de estos años se han desarrollado y validado distintas técnicas para el diagnóstico rápido de estas micosis y se han realizado diferentes trabajos encaminados a un mejor conocimiento de los hongos que las causan.
Las técnicas desarrolladas a lo largo de estos años se han incorporado a la Cartera de Servicios del Centro Nacional de Microbiología para ofrecerlas al Sistema Nacional de Salud. Además, algunas de ellas se han patentado.
Research projects
Content with Investigacion .
1. Nombre del proyecto: Mejora del pronóstico del paciente con riesgo de enfermedad fúngica invasora: estudio de susceptibilidad del huésped y desarrollo de nuevos métodos de diagnóstico clínico. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2018 - 31/12/2020. Cuantía: 72.000 €. Investigadores principales (IP, Co-IP,...): María José Buitrago Serna/Laura Alcazar Fuoli
2. Nombre del proyecto: Red española de Investigación en Patologías infecciosas REIPI
Entidad/es financiadora/s: ISCIII-FEDER Fecha de inicio-fin: 01/01/2017 - 31/12/2021
Cuantía total: 195.612 €. Coordinador: Emilia Mellado
3. Nombre del proyecto: Desarrollo y validación de un método de detección de tipo “point of care”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2015 - 31/12/2017. Cuantía total: 46.000 €. Investigador principal: María José Buitrago.
4. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2(Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory). Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2016 - 01/06/2017. Cuantía total: 524.848 €. Cuantía subproyecto: 141.562 €. Coordinador (IP): Raoul Hervé.
5. Nombre del proyecto: Iberian network of laboratories of Biological Alert Acreditation of methods for detection of highly pathogenic agents/IB-BiOALERNET Entidad/es financiadora/s: DG-Home (Unión Europea). Fecha de inicio-fin: 2013 – 2015. Cuantía total: 629.382,67 €. Coordinador (IP): Carmen Cañavate
6. Nombre del proyecto: Desarrollo de nuevos métodos de diagnóstico e identificación de especies fúngicas causantes de neumonías oportunistas. Entidad/es financiadora/s: ISCIII. Fecha de inicio-fin: 2012 – 2015. Cuantía total: 67.429,67 €. Investigador principal: María José Buitrago.
7. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2 (Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory. Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2010 - 31/12/2013. Cuantía total: 4.859.782,5 €. Coordinador (IP): Raoul Hervé.
8. Nombre del proyecto: RED iberoamericana de diagnóstico molecular de las infecciones endémicas y oportunistas. Entidad/es financiadora/s: CYTED-AECI. Fecha de inicio-fin: 2008 – 2009. Cuantía total: 70.000 €. Investigador principal: Luz-Elena Cano
9. Nombre del proyecto: “Desarrollo de nuevos métodos de diagnóstico en alertas biosanitarias relacionadas con la Micología”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 2007 – 2009. Cuantía total: 58.500 €. Investigador Principal: María José Buitrago
Publications
Detection of Rhabdovirus viral RNA in oropharyngeal swabs and ectoparasites of Spanish bats
Aznar C, Vazquez-Moron S, Martson D, Juste J, Ibáñez C, Berciano JM, Salsamendi E, Aihartza J, Banyard AC, McElhinney L, Fooks AR, Echevarria JE. Detection of Rhabdovirus viral RNA in oropharyngeal swabs and ectoparasites of Spanish bats. Journal of General Virology. 2013. 94: 69-75.
PUBMED DOIGenomic non-coding regions reveal hidden patterns of mumps virus circulation in Spain, 2005 to 2015
Gavilán AM, Fernández-García A*, Rueda A, Castellanos A, Masa J, López-Perea N, Torres de Mier MV, de Ory F, Echevarría JE. Non-coding sequences reveal hidden patterns of mumps virus circulation in Spain, 2005 to 2015. Eurosurveillance,2018, 23(15): 1-8. *Corresponding author.
PUBMED DOIFirst cases of European Bat Lyssavirus type 1 in Iberian serotine bats: implications for the molecular epidemiology of bat rabies in Europe.
Mingo-Casas P, Sandonís V, Obón E, Berciano JM, Vázquez-Morón S, Juste J, Echevarría JE. First cases of European Bat Lyssavirus type 1 in Iberian serotine bats: implications for the molecular epidemiology of bat rabies in Europe. Plos Neglected Tropical Diseases, 2018: 12(4): e0006290.
PUBMED DOILast cases of rubella and congenital rubella syndrome in Spain, 1997–2016: The success of a vaccination program
Seppälä EM, López-Perea N, Torres de Mier MV, Echevarría JE, Fernández García A, Masa-Calles J. Last cases of rubella and congenital rubella syndrome in Spain, 1997–2016: The success of a vaccination program. Vaccine, 2019, 37(1):169-175.
PUBMED DOICombination of Cefditoren and N-acetyl-l-Cysteine Shows a Synergistic Effect against Multidrug-Resistant Streptococcus pneumoniae Biofilms
Llamosí M, Sempere J, Coronel P, Gimeno M, Yuste J, Domenech M. Combination of Cefditoren and N-acetyl-l-Cysteine Shows a Synergistic Effect against Multidrug-Resistant Streptococcus pneumoniae Biofilms. Microbiol Spectr. 2022 Dec 21;10(6):e0341522
PUBMED DOIClearance of mixed biofilms of Streptococcus pneumoniae and methicillin-susceptible/resistant Staphylococcus aureus by antioxidants N-acetyl-L-cysteine and cysteamine
Sempere J, Llamosí M, Román F, Lago D, González-Camacho F, Pérez-García C, Yuste J, Domenech M. Clearance of mixed biofilms of Streptococcus pneumoniae and methicillin-susceptible/resistant Staphylococcus aureus by antioxidants N-acetyl-L-cysteine and cysteamine. Sci Rep. 2022 Apr 23;12(1):6668
PUBMED DOIClinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain
Sempere J, de Miguel S, González-Camacho F, Yuste J, Domenech M. Clinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain. Front Microbiol. 2020 Feb 27;11:309.
PUBMED DOICombination of Antibodies and Antibiotics as a Promising Strategy Against Multidrug-Resistant Pathogens of the Respiratory Tract
Domenech M, Sempere J, de Miguel S, Yuste J. Combination of Antibodies and Antibiotics as a Promising Strategy Against Multidrug-Resistant Pathogens of the Respiratory Tract. Front Immunol. 2018 Nov 20;9:2700. doi: 10.3389/fimmu.2018.02700. PMID: 30515172; PMCID: PMC6256034.
DOIChemotherapy with Phage Lysins Reduces Pneumococcal Colonization of the Respiratory Tract
Corsini B, Díez-Martínez R, Aguinagalde L, González-Camacho F, García-Fernández E, Letrado P, García P, Yuste J. Chemotherapy with Phage Lysins Reduces Pneumococcal Colonization of the Respiratory Tract. Antimicrob Agents Chemother. 2018 May 25;62(6):e02212-17. doi: 10.1128/AAC.02212-17. PMID: 29581113; PMCID: PMC5971604.
DOIImpact of Biological Therapies on the Immune Response after Pneumococcal Vaccination in Patients with Autoimmune Inflammatory Diseases
Richi P, Yuste J, Navío T, González-Hombrado L, Salido M, Thuissard-Vasallo I, Jiménez-Díaz A, Llorente J, Cebrián L, Lojo L, Steiner M, Cobo T, Martín MD, García-Castro M, Castro P, Muñoz-Fernández S. Impact of Biological Therapies on the Immune Response after Pneumococcal Vaccination in Patients with Autoimmune Inflammatory Diseases. Vaccines. 2021 Feb 28;9(3):203. doi: 10.3390/vaccines9030203. PMID: 33671007; PMCID: PMC7997274.
DOIPleiotropic Effects of Cell Wall Amidase LytA on Streptococcus pneumoniae Sensitivity to the Host Immune Response
Ramos-Sevillano E, Urzainqui A, Campuzano S, Moscoso M, González-Camacho F, Domenech M, Rodríguez de Córdoba S, Sánchez-Madrid F, Brown JS, García E, Yuste J. Pleiotropic effects of cell wall amidase LytA on Streptococcus pneumoniae sensitivity to the host immune response. Infect Immun. 2015 Feb;83(2):591-603. doi: 10.1128/IAI.02811-14. PMID: 25404032; PMCID: PMC4294232.
DOIPSGL-1 on Leukocytes is a Critical Component of the Host Immune Response against Invasive Pneumococcal Disease
Ramos-Sevillano E, Urzainqui A, de Andrés B, González-Tajuelo R, Domenech M, González-Camacho F, Sánchez-Madrid F, Brown JS, García E, Yuste J. PSGL-1 on Leukocytes is a Critical Component of the Host Immune Response against Invasive Pneumococcal Disease. PLoS Pathog. 2016 Mar 14;12(3):e1005500. doi: 10.1371/journal.ppat.1005500. PMID: 26975045; PMCID: PMC4790886.
DOIComparison of methods and characterization of small RNAs from plasma extracellular vesicles of HIV/HCV coinfected patients
Martínez-González E; Brochado-Kith O; Gómez-Sanz A; et al; Fernández-Rodríguez A (AC). (9/9). 2020. Small RNA sequencing from plasma extracellular vesicles of HIV/HCV coinfected patients: a protocol comparison SCIENTIFIC REPORTS. 9. ISSN 2045-2322.
DOIRelative telomere length impact on mortality of COVID-19: Sex differences
Virseda-Berdices A; Concostrina-Martinez L; Martínez-González O;et al; Fernández-Rodríguez A (AC). (14/14). 2022. Relative telomere length impact on mortality of COVID-19: Sex differences.Journal of medical virology. 95, pp.e28368. ISSN 0146-6615.
DOIHepatitis C Virus Influences HIV-1 Viral Splicing in Coinfected Patients
Martínez-Román P; López-Huertas MR; Crespo-Bermejo C; et al; Briz V (AC). (16/15). 2020. Hepatitis C virus influences HIV-1 viral splicing in coinfected patients JOURNAL OF CLINICAL MEDICINE. MDPI. ISSN 2077-0383.
DOIHCV eradication with IFN-based therapy does not completely restore gene expression in PBMCs from HIV/HCV-coinfected patients
Brochado-Kith; Martínez I; Berenguer J; et al; Fernández-Rodríguez A (AC); Resino S. (11/12). 2021. HCV eradication with IFN-based therapy does not completely restore gene expression in PBMCs from HIV/HCV-coinfected patients. Journal of Biomedical Sciences. Springer Nature. 28-1.
DOIOLFM4 polymorphisms predict septic shock survival after major surgery. Eur J Clin Invest.
Pérez-García F; Resino S; Gómez-Sánchez E; et al; Jiménez-Sousa MÁ (10/10). OLFM4 polymorphisms predict septic shock survival after major surgery. Eur J Clin Invest. 2021. 51(4):e13416. doi: 10.1111/eci.13416.
Alcazar-Fuoli L, Mellado E, Garcia-Effron G, Buitrago MJ, Lopez JF, Grimalt JO, Cuenca-Estrella JM, Rodriguez-Tudela JL. Aspergillus fumigatus C-5 sterol desaturases Erg3A and Erg3B: role in sterol biosynthesis and antifungal drug susceptibility. Antimicrob Agents Chemother. 2006 Feb
Alcazar-Fuoli L, Mellado E, Garcia-Effron G, Buitrago MJ, Lopez JF, Grimalt JO, Cuenca-Estrella JM, Rodriguez-Tudela JL. Aspergillus fumigatus C-5 sterol desaturases Erg3A and Erg3B: role in sterol biosynthesis and antifungal drug susceptibility. Antimicrob Agents Chemother. 2006 Feb;50(2):453-60. doi: 10.1128/AAC.50.2.453-460.2006. PMID: 16436696; PMCID: PMC1366924.
PUBMED14. Alcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, Cuenca-Estrella M, Rodriguez-Tudela JL. Aspergillus section Fumigati: antifungal susceptibility patterns and sequence-based identification. Antimicrob Agents Chemother. 2008 Apr
Alcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, Cuenca-Estrella M, Rodriguez-Tudela JL. Aspergillus section Fumigati: antifungal susceptibility patterns and sequence-based identification. Antimicrob Agents Chemother. 2008 Apr;52(4):1244-51. doi: 10.1128/AAC.00942-07. Epub 2008 Jan 22. PMID: 18212093; PMCID: PMC2292508.
PUBMED DOIAlcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, Cuenca-Estrella M, Rodriguez-Tudela JL. Species identification and antifungal susceptibility patterns of species belonging to Aspergillus section Nigri. Antimicrob Agents Chemother. 2009 Oct
Alcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, Cuenca-Estrella M, Rodriguez-Tudela JL. Species identification and antifungal susceptibility patterns of species belonging to Aspergillus section Nigri. Antimicrob Agents Chemother. 2009 Oct;53(10):4514-7. doi: 10.1128/AAC.00585-09. Epub 2009 Jul 27. PMID: 19635955; PMCID: PMC2764190.
PUBMED DOIContent with Investigacion .
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Leticia Bernal Martínez
Staff Scientist
ORCID code: 0000-0002-1694-5522
Dr. Bernal-Martínez obtained her degree in Biochemistry from the University of Zaragoza in 2005. She joined the Mycology Reference and Research Laboratory (LRIM) in 2006 under a trainee contract and completed her PhD within the Official Doctoral Program in Microbiology and Parasitology at the Complutense University of Madrid, defending her thesis in 2010 with highest honors (Cum Laude). In 2007, she continued her research activity at LRIM within the framework of the Spanish Network for Research in Infectious Diseases (REIPI). In 2016, she completed a Postgraduate Diploma in Promotion and Management of International Projects (Technical University of Madrid) and undertook a research stay at the Microbiology and Infection Research Domain, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho (Braga, Portugal). She was subsequently appointed as a PhD researcher within the Biomedical Research Networking Center in Infectious Diseases (CIBERINFEC). Since 2024, she serves as Specialist Scientist at the Carlos III Health Institute (ISCIII) and is responsible for the Diagnostic and Serology Section for Endemic Fungi at the Mycology Reference and Research Laboratory.
Dr. Bernal-Martínez has authored more than 30 peer-reviewed scientific publications and two book chapters. She has actively participated in over 12 research projects and has presented her work at numerous national and international scientific conferences. Her research has focused on human fungal infections, antifungal resistance, therapeutic drug monitoring, genetic variants associated with antifungal metabolism, and the identification of predictive biomarkers of invasive fungal infections. However, her primary expertise lies in the diagnostic field, particularly in the design, optimization, and validation of real-time PCR–based methodologies.
She is currently Principal Investigator of a research project aimed at improving current diagnostic techniques for invasive fungal infections, evaluating emerging diagnostic technologies, and studying primary fungal pathogens. A substantial part of her work has been transferred to the Spanish National Health System and to research centers in Latin America. Many of the diagnostic methodologies developed have been incorporated into the official service portfolio of ISCIII. She has collaborated with multiple hospitals through research projects and clinical trials applying these technologies, as well as with the ISCIII spin-off company Micomol S.L.
Dr. Bernal-Martínez has supervised several Master’s and Undergraduate Final Degree Projects from students at the Complutense University of Madrid and the University of Alcalá. She is a member of the teaching staff of the UNED-ISCIII PhD Program in Biomedical Sciences and Public Health and serves as lecturer in the Master’s Program in Public Health and Research in Infectious Diseases at the University of Alcalá.
List of staff
Additional Information
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010