Improving hybrid image and structure-based deformable image registration for large internal deformations.

Objective.Deformable image registration (DIR) is a widely used technique in radiotherapy. Complex deformations, resulting from large anatomical changes, are a regular challenge. DIR algorithms generally seek a balance between capturing large deformations and preserving a smooth deformation vector field (DVF). We propose a novel structure-based term that can enhance the registration efficacy while ensuring a smooth DVF.Approach.The proposed novel similarity metric for controlling structures was introduced as a new term into a commercially available algorithm. Its performance was compared to the original algorithm using a dataset of 46 patients who received pelvic re-irradiation, many of which exhibited complex deformations.Main results.The mean Dice Similarity Coefficient (DSC) under the improved algorithm was 0.96, 0.94, 0.76, and 0.91 for bladder, rectum, colon, and bone respectively, compared to 0.69, 0.89, 0.62, and 0.88 for the original algorithm. The improvement was more pronounced for complex deformations.Significance.With this work, we have demonstrated that the proposed term is able to improve registration accuracy for complex cases while maintaining realistic deformations.

Inter-laboratory method validation of CD34+ flow-cytometry assay: the experience of Turin Metropolitan Transplant Centre.

The Turin Metropolitan Transplant Centre (CIC 305) includes four flow-cytometry laboratories assessing quality control on hematopoietic stem cells (HSC) with different instruments and operators. Therefore, the CD34+ enumeration assay should be validated on a regular basis. We describe here the validation plan to test the inter-laboratory reproducibility of CD34+ enumeration assay, based on the risk analysis. Stabilized blood samples were analysed using Stem-Kit reagent according to manufacturer's instructions and acquired using the Beckman Coulter Navios at Regina Margherita Children's' Hospital (305-1), Beckman Coulter FC500 at Candiolo Cancer Institute FPO-IRCCS (305-2), BD Biosciences FACSLyric™ at S. Luigi Hospital (305-3), and Beckman Coulter Navios EX at Mauriziano Hospital (305-4). The ISHAGE guidelines were followed for estimating % and absolute number of CD34+ cells in single-platform method. For each sample repeatability limit (r), reproducibility error, uncertainty of reproducibility error and coefficient of variation (CV) were reported. The repeated measurements from each laboratory or instrument have a variability, expressed as reproducibility error, lower than the repeatability limit for that single parameter. The corrected reproducibility error is always lower than the repeatability limit except for the percentage value of the "low" count. The analysis of inter-laboratory variance is within the maximum acceptable variance value, and the CV of all measurements for each parameter is less than 8%, indicating low measurement variability among laboratories. Evaluating the overall data, we can conclude that the four laboratories are perfectly aligned and the results are reproducible.

Síndrome de rotura de Varsovia: una causa de microcefalia congénita y sordera neurosensorial / Warsaw breakage syndrome: an etiology for congenital microcephaly and sensorineural deafness

Introducción: El síndrome de rotura de Varsovia es una alteración genética muy poco frecuente originada por variantes patógenas bialélicas en el gen DDX11, implicado en la cohesión de las cromátidas hermanas, que pertenece al grupo de las cohesinopatías. Clínicamente se caracteriza por retraso del crecimiento, microcefalia y sordera neurosensorial, con otras manifestaciones menos frecuentes: dismorfia facial, anomalías esqueléticas, cardíacas, cutáneas y genitourinarias. Caso clínico: Presentamos a un varón con las manifestaciones cardinales del síndrome: bajo peso en el nacimiento, microcefalia congénita grave y sordera neurosensorial con agenesia de los nervios cocleares. También presenta cardiopatía, hipospadias, criptorquidia, anomalía cutánea y pies planos. En el exoma se han identificado dos variantes en heterocigosis probablemente patógenas en el gen DDX11, c.1403dup; p.(Ser469Valfs*32) y c.2371C>T; p.(Arg791Trp), heredadas cada una de un progenitor. Conclusión: Revisamos a los 23 pacientes descritos con el síndrome en la bibliografía, tanto desde el punto de vista clínico como desde el genético. Analizamos el significado etiopatógeno de las variantes de nuestro caso basándonos en los datos moleculares y las funciones celulares de DDX11 de los estudios publicados. Debido al solapamiento clínico con los síndromes con rotura cromosómica y las cohesinopatías, debemos realizar el diagnóstico diferencial con estas entidades, fundamentalmente la anemia de Fanconi, el síndrome de rotura de Nijmegen, el síndrome de Cornelia de Lange y el síndrome de Roberts. En la práctica clínica, debemos sospechar este síndrome en el período neonatal en un paciente con retraso del crecimiento intrauterino, microcefalia grave y sordera neurosensorial.(AU)

Introduction: Warsaw breakage syndrome is a very rare genetic disorder due to biallelic pathogenic variants in DDX11 gene, with a role in the sister chromatid cohesion process, and classified in the cohesinophaties group. It is characterized by the clinical triad of growth restriction, microcephaly and sensorineural deafness. Additional, but less frequent features, are facial dysmorphism, and skeletal, heart, skin and genitourinary anomalies. Case report: We report a boy with the cardinal features of the syndrome: prenatal growth restriction, severe congenital microcephaly, and sensorineural deafness with cochlear nerves agenesis. He also has a cardiac anomaly, hypospadias, cryptorchidism, skin abnormality, and pes planus. The exome yielded two heterozygous likely pathogenic variants in the DDX11 gene, c.1403dup; p.(Ser469Valfs*32) and c.2371C>T; p.(Arg791Trp), inherited in trans from the parents. Conclusion: We review the clinical and genetic data of the 23 reported cases with the syndrome in the literature and analyze the etiopathogenic interpretation of our case variants based on the molecular and cellular functions of DDX11 described. Due to the clinical overlap with the chromosomal breakage syndromes and cohesinopathies we must make the differential diagnosis with these entities, overall, with Fanconi anemia, Nijmegen breakage syndrome, Cornelia de Lange syndrome and Roberts syndrome. In clinical practice we must think in Warsaw breakage syndrome in the neonatal period in a patient with intrauterine growth restriction, severe microcephaly, and sensorineural deafness.(AU)

[Warsaw breakage syndrome: an etiology for congenital microcephaly and sensorineural deafness]. / Síndrome de rotura de Varsovia: una causa de microcefalia congénita y sordera neurosensorial.

INTRODUCTION: Warsaw breakage syndrome is a very rare genetic disorder due to biallelic pathogenic variants in DDX11 gene, with a role in the sister chromatid cohesion process, and classified in the cohesinophaties group. It is characterized by the clinical triad of growth restriction, microcephaly and sensorineural deafness. Additional, but less frequent features, are facial dysmorphism, and skeletal, heart, skin and genitourinary anomalies. CASE REPORT: We report a boy with the cardinal features of the syndrome: prenatal growth restriction, severe congenital microcephaly, and sensorineural deafness with cochlear nerves agenesis. He also has a cardiac anomaly, hypospadias, cryptorchidism, skin abnormality, and pes planus. The exome yielded two heterozygous likely pathogenic variants in the DDX11 gene, c.1403dup; p.(Ser469Valfs*32) and c.2371C>T; p.(Arg791Trp), inherited in trans from the parents. CONCLUSION: We review the clinical and genetic data of the 23 reported cases with the syndrome in the literature and analyze the etiopathogenic interpretation of our case variants based on the molecular and cellular functions of DDX11 described. Due to the clinical overlap with the chromosomal breakage syndromes and cohesinopathies we must make the differential diagnosis with these entities, overall, with Fanconi anemia, Nijmegen breakage syndrome, Cornelia de Lange syndrome and Roberts syndrome. In clinical practice we must think in Warsaw breakage syndrome in the neonatal period in a patient with intrauterine growth restriction, severe microcephaly, and sensorineural deafness.

TITLE: Síndrome de rotura de Varsovia: una causa de microcefalia congénita y sordera neurosensorial.Introducción. El síndrome de rotura de Varsovia es una alteración genética muy poco frecuente originada por variantes patógenas bialélicas en el gen DDX11, implicado en la cohesión de las cromátidas hermanas, que pertenece al grupo de las cohesinopatías. Clínicamente se caracteriza por retraso del crecimiento, microcefalia y sordera neurosensorial, con otras manifestaciones menos frecuentes: dismorfia facial, anomalías esqueléticas, cardíacas, cutáneas y genitourinarias. Caso clínico. Presentamos a un varón con las manifestaciones cardinales del síndrome: bajo peso en el nacimiento, microcefalia congénita grave y sordera neurosensorial con agenesia de los nervios cocleares. También presenta cardiopatía, hipospadias, criptorquidia, anomalía cutánea y pies planos. En el exoma se han identificado dos variantes en heterocigosis probablemente patógenas en el gen DDX11, c.1403dup; p.(Ser469Valfs*32) y c.2371C>T; p.(Arg791Trp), heredadas cada una de un progenitor. Conclusión. Revisamos a los 23 pacientes descritos con el síndrome en la bibliografía, tanto desde el punto de vista clínico como desde el genético. Analizamos el significado etiopatógeno de las variantes de nuestro caso basándonos en los datos moleculares y las funciones celulares de DDX11 de los estudios publicados. Debido al solapamiento clínico con los síndromes con rotura cromosómica y las cohesinopatías, debemos realizar el diagnóstico diferencial con estas entidades, fundamentalmente la anemia de Fanconi, el síndrome de rotura de Nijmegen, el síndrome de Cornelia de Lange y el síndrome de Roberts. En la práctica clínica, debemos sospechar este síndrome en el período neonatal en un paciente con retraso del crecimiento intrauterino, microcefalia grave y sordera neurosensorial.

Hallazgo casual al regresar de un viaje / Chance find when returning from a trip

Se trata de un varón de 34 años que tras regresar de un viaje transatlántico consulta por dolor pleurítico derecho, malestar general, sudoración y tos productiva. Presenta alteraciones radiológicas compatibles con tromboembolismo pulmonar (TEP) bilateral, patrón micronodular y adenopatías mediastínicas que podrían estar en relación con algún proceso infeccioso-inflamatorio por el que inicia estudio. Tras aplicar una amplia estrategia diagnóstica y excluir otras enfermedades, el resultado es compatible con TEP bilateral coincidente con sarcoidosis pulmonar estadio II. El paciente evoluciona posteriormente de forma favorable con tratamiento corticoideo. (AU)

This is a 34-year-old man who, after returning from a transatlantic trip, consulted for right pleuritic pain, general malaise, sweating, and a productive cough. He presented radiological alterations compatible with bilateral pulmonary thromboembolism (PTE), a micronodular pattern and mediastinal lymphadenopathies that could be related to some infectious-inflammatory process for which he began the study. After applying a broad diagnostic strategy and excluding other diseases, the result is compatible with bilateral PET coinciding with stage II pulmonary sarcoidosis. The patient subsequently evolves favorably with corticosteroid treatment. (AU)

Controlling Nonlinear Dynamics of Milling Bodies in Mechanochemical Devices Driven by Pendular Forcing.

Understanding the dynamics of milling bodies is key to optimize the mixing and the transfer of mechanical energy in mechanochemical processing. In this work, we present a comparative study of mechanochemical reactors driven by harmonic pendular forcing and characterized by different geometries of the lateral borders. We show that the shape of the reactor bases, either flat or curved, along with the size of the milling body and the elasticity of the collisions, represents relevant parameters that govern the dynamical regimes within the system and can control the transition from periodic to chaotic behaviors. We single out possible criteria to preserve target dynamical scenarios when the size of the milling body is changed, by adapting the relative extent of the spatial domain. This allows us to modulate the average energy of the collisions while maintaining the same dynamics and paves the way for a unifying framework to control the dynamical response in different experimental conditions. We finally explore the dynamical and energetic impact of an increasingly asymmetric mechanical force.

Enuresis: clinical evolution of patients attended at specialized unit of paediatric urology

OBJECTIVE: To analyse the clinical evolution, the therapeutic strategies and the characteristics of the patients presenting enuresis attended at our outpatient clinic. MATERIAL AND METHODS: Retrospective study of patients <14 years old(yo) diagnosed of enuresis attended at our outpatient clinic (2011-2019) and completed their follow-up (remission or aged 15). Urotherapy was offered to all patients as initial management. The therapeutic strategies were classified as: first line (desmopressin or clock alarm), second line (desmo-pressin+alarm) and third line(anticholinergics). The remission rate during follow-up, the number of consultations needed until remission and the treatments used were calculated. Statistical tests used:Kaplan-Meier, actuarial survival. Multivariate analysis:Cox regression.Statistical significance:p<0.05. RESULTS: Data were collected from 125 patients (mean age: 8.6±2.45yo). Family history of enuresis was present in 38.9%. The mean follow-up was 2.37±1.55yo and the average number of consultations was 7.54±5.06. The remission rate (RE) was 84%(n=105), with a median remission interval:2.66 years (2.34-2.991[95%CI]). The average number of treatments required for remission was 2.74±1.27. RE with urotherapy alone was 20%(n=25); RE with first line:19.3%(n=17) and second line:16.7(n=11). In the remaining patients, a RE of 78.18%(n=43) was achieved by adding an anticholinergic. Patients aged > 8.7 years at the beginning of the follow-up required less time to achieve remission (p=.025). These patients had a higher RE (hazard ratio 1.15 (1.05-1.25))(p=.004). No other variables were significant. CONCLUSION: Staged therapeutic strategies are necessary to achieve remission. Only 25% remitted with urotherapy as single treatment. RE are higher when patients are >8.7 yo once they initiate their follow up (AU)

A pesar de la existencia de lasguías clínicas sobre el manejo terapéutico de la enuresis,un gran porcentaje de estos pacientes son resistentes altratamiento.OBJETIVO: Analizar la evolución clínica, las estrategias terapéuticas y las características de los pacientescon enuresis de nuestra unidad deMATERIAL Y MÉTODOS: Estudio retrospectivode pacientes menores de 14 años con enuresis atendidos ennuestro servicio (2011-2019) y que hayan completado suseguimiento (remisión o edad > 15 años). La uroterapia seofreció como tratamiento inicial en todos. Las siguientesestrategias terapéuticas fueron: primera línea terapéutica(desmopresina o alarma), segunda(desmopresina+alarma)y tercera(anticolinérgicos). Se calculó el porcentaje deremisión (RE) durante el seguimiento, el número de consultas empleadas hasta la RE y el tratamiento utilizado.Test estadísticos:Kaplan-Meier, supervivencia acumulada.Análisis multivariante:Regresión Cox. Significación estadística: p<0.05.RESULTADOS: Se recogieron datos de 125 pacientes(media de edad: 8.6±2.45 años). Los antecedentesfamiliares de enuresis fueron del 38.9%. La media de edadde seguimiento fue 2.37±1.55 años y el número mediode consultas fue de 7.54±5.06. El porcentaje de RE fuede 84%(n=105), con una mediana de intervalo de RE de2.66 años(2.34-2.991[95%CI]. La media de tratamientosempleados fue de 2.74±1.27. La RE con sólo uroterapiafue del 20%(n=25); RE con primera línea de tratamiento:19.3%(n=17) y con segunda: 16.7(n=11). En el resto, laRE fue del 78.18%(n=43) añadiendo anticolinérgicos. Lospacientes mayores de 8.7 años en el inicio del seguimientonecesitaban menor tiempo para conseguir la RE(p=.025).Estos pacientes tenían un porcentaje mayor deCONCLUSIONES: Es necesario emplear estrategiasescalonadas para la remisión. Solo un cuarto remite conuroterapia aislada. Es importante la edad de los pacientesen el inicio del seguimiento pues el porcentaje...(AU)

Consultas de tabaquismo en las UnidadesMultidisciplinares de Asma: nuestra experiencia / Consultations on smoking habit in the Multidisciplinary Asthma Units: our experience

No disponible

"Early" and "definitive" taking charge of subjects positive to SARS-CoV2: the experience of an Italian Local Health Authority.

Abstract: During the second covid-19 pandemic wave in November-December 2021 Prevention Departments had to face a hardly-sustainable workload of contact tracing and taking charge of the sars-cov2 positive case and of his or her close contacts. Also laboratories have been stressed in their ability to process timely the extraordinary load of swabs performed. In this context of hazardous delays, the Prevention Department of Belluno (Italy) tested its resilience: a simple and effective method of taking charge was implemented, by initially phoning to the positive case and imposing the isolation measure on him or her and later on proceeding with the conventional contact tracing.

External Beam Radiotherapy in Western Africa: 1969-2019.

AIMS: We describe the absolute and per capita numbers of megavoltage radiotherapy machines (MVMs) in Western Africa from 1969 to 2019. MATERIALS AND METHODS: Western Africa was defined in accordance with the United Nations' delineation and inclusive of 16 countries. A literature search for publications detailing the number of cobalt-60 machines (COs) and linear accelerators (LINACs) in radiotherapy centres was carried out. Population data from the World Bank Group and crude cancer rates from the International Agency for Research on Cancer were used to calculate ratios of million persons per MVM and MVMs per 1000 cancer cases. RESULTS: The numbers of MVMs in Western Africa in 1969, 1979, 1989, 1999 and 2009 were zero, two, three, six and nine, respectively. In 2019 there were 22 MVMs distributed across Ghana (five), Côte d'Ivoire (two), Mali (one), Mauritania (two), Nigeria (nine) and Senegal (three). Nine countries (56.3%) had no history of external beam radiotherapy (EBRT). The largest increase in absolute EBRT capacity occurred from 2017 to 2019, during which 13 MVMs were commissioned. The largest decrease in EBRT capacity occurred from 2015 to 2017, during which four LINACs and three COs were rendered non-operational. The ratio of million persons per MVM improved from 67.0 in 1979 to 17.8 in 2019. As of 2019, there was 0.09 MVM per 1000 cancer cases. CONCLUSIONS: Western African nations have experienced an increase in the absolute number of MVMs and per capita radiotherapy capacity during the last 50 years, especially in the last decade. As non-functional LINACs contributed to a temporary decline in the EBRT infrastructure, dual use of CO/LINAC technologies may act to promote the availability of EBRT treatment in centres with capacity for multiple MVMs.

Aluminum oxides as alternative building blocks for efficientlayer-by-layerblocking layers in dye-sensitized solar cells.

All inorganic layer-by-layer (LbL) thin films composed by TiO2nanoparticles and [Al(OH)4]-anions (TiO2/AlOx) as well as Al2O3and Nb2O5nanoparticles (Al2O3/Nb2O5) have been deposited to fluorine-doped tin-oxide coated glass (FTO) surfaces and applied as blocking layers in dye-sensitized solar cells (DSCs). Structural and morphological characterization of the LbL films by different techniques reveal that inTiO2/AlOxassembly, aluminate anions undergo condensation reactions on the TiO2surface leading to the formation of highly homogeneous films with unique optical properties. After 25 depositions transmittance losses below 10% in relation to the bare FTO substrate are observed. Electrochemical impedance spectroscopy shows thatTiO2/AlOxlayers impose an effective barrier for the charge recombination at FTO/electrolyte interface with an electron exchange time constant 50-fold higher than that for bare FTO. As a result, an improvement of 85% in the overall conversion efficiency of DSCs was observed with the employment of TiO2/AlOxblocking layers.Al2O3/Nb2O5LbL films can also work as blocking layers in DSCs but not as efficient, which is associated with the poor homogeneity of the film and its capacitive behavior. The production of cost-effective blocking layers with a low light scattering in the visible region is an important feature toward the application of DSC in other Building-integrated photovoltaic applications.

Oxidation of sulfonamides by ferrate(VI): Reaction kinetics, transformation byproducts and toxicity assesment.

This study was aimed at the degradation of sulfonamides (SNs) via oxidation with Fe(VI). The reaction kinetics, identification of degradation byproducts and their toxicity were investigated. The pH solution and Fe(VI) loading had significant effects on the degradation of the sulfonamides. The maximum degradation rate occurred at pH 3.0 with a 6:1 ratio Fe(VI): sulfonamide, obtaining 100% degradation of 15 mg L-1 SN within 5 min. Although Fe(VI) also showed an appreciable reactivity towards SNs (kapp = 9.85-19.63 × 102 M-1 s-1) at pH 7. The influence of solution pH on the values of kapp can be explained considering the specific reaction between Fe(VI) and SNs. Degradation rates are also influenced by the presence of inorganic ions in different water matrixes. For this reason, ions present in groundwater enhanced the SNs degradation through a synergistic effect among carbonates, sulfates and Fe(VI). Degradation byproducts identified, through UPLC analysis, allowed us to proposed three degradation pathways depending on pH. At acid pH there is a cleavage of C-S and S-N bonds. At neutral pH nitroso and nitro-derivates are formed. At basic pH hydroxylation is the main reaction. The cytotoxicity assay of HEK-293 and J774 cell lines exposed to Fe(VI) indicated that transformation byproducts had a lower toxicity than SNs as baseline products. Accordingly, this research suggests that Fe(VI) can act as a chemical oxidant to remove SNs antibiotics and it can be used to treat antibiotic pollution in wastewater.

Hiperactividad paroxística simpática secundaria a una encefalitis herpética / Paroxysmal sympathetic hyperactivity after herpetic encephalitis

INTRODUCCIÓN: La hiperactividad simpática paroxística (HSP) es un síndrome caracterizado por episodios repetidos de aumento de actividad simpática (taquicardia, taquipnea, hipertensión arterial, fiebre, sudoración) y actividad motora (distonía, hiperextensión) en pacientes con un daño cerebral adquirido. CASO CLÍNICO: Presentamos el caso de un lactante con HSP secundaria a una encefalitis aguda por el virus del herpes simple tipo 1. CONCLUSIÓN: La HSP es una entidad infradiagnosticada, cuyo tratamiento, basado en la combinación de fármacos, debe ser precoz para evitar comorbilidades y mejorar su pronóstico

INTRODUCTION: Paroxysmal sympathetic hyperactivity (PSH), previously known as dysautonomia or sympathetic storming, is a syndrome characterized by repeated episodes of increases in sympathetic activity (tachycardia, tachypnoea, hypertension, fever and sweating) and motor activity (dystonia, hyperextension) in patients with an acquired brain injury. CASE REPORT: We present the case of a toddler with PSH after acute encephalitis by herpes simplex virus 1. CONCLUSIONS: The PSH is an underdiagnosed entity whose treatment, based on the combination of different drugs, must be premature to avoid comorbidities and to improve its prognosis

Toxicity and inhibition assessment of ionic liquids by activated sludge.

Toxicity of 13 ionic liquids (ILs) corresponding to different families were studied by inhibition respiration assays (15 min) using activated sludge. Toxicity increased as increasing the number of carbons in the alkyl-chain of imidazolium-based ILs, with EC50 values from 4.19 to 0.17 for 1-ethyl-3-methylimidazolium chloride ([Emim][Cl]) and 1-octyl-3-methylimidazolium chloride ([Omim][Cl]), respectively. An increase in toxicity was observed for aromatic-based ILs (pyridinium- and imidazolium-based ILs) due to the hydrophobic character of the head groups in comparison with linear structures as phosphonium and ammonium cations. Among to the anions studied fixing [Emim]+ as cation, [HSO4]- and [NTf2]- presented low EC50 values (0.34 mM and 1.69 mM, respectively) while [Cl]- and [EtSO4]- were considered harmless anions due to the hydrophilic character of chloride and the organic nature of [EtSO4]-. ILs toxicity/inhibition was determined by adding a biodegradable compound and measuring the sludge response after being in contact with the ILs for at least 15 h. The exposure of sewage sludge to ILs for more than 15 min used in short inhibition assays caused more toxic effect on microorganisms, even for [Choline][NTf2], previously defined as practically harmless (EC50 = 2.79 mM). Biodegradability assays confirmed the biodegradable nature of choline cation, related with TOC conversion of 40%, only due to cation consumption. No oxygen consumption or even lysis of microbial cells was observed for Tetrabutylammonium bis(trifluoromethylsulfonyl)imide and for 1-Ethyl-3-methylimidazolium hydrogensulphate due to the presence of anions previously defined as hazardous ([NTf2]- and [HSO4]-), maintaining their recalcitrant character to sewage systems.

Halide removal from water using silver doped magnetic-microparticles.

This study proposes the use of new materials based on core-shell structure magnetic microparticles with Ag0 (Ag(0)-MPs) on their surface to remove bromides and chlorides from waters intended for human consumption. Hydrogen peroxide was used as oxidizing agent, Ag(0)-MPs is thereby oxidized to Ag (I)-MPs, which, when in contact with Cl- and Br- ions, form the corresponding silver halide (AgCl and AgBr) on the surface of Ag-MPs. The concentration of Cl- and Br- ions was followed by using ion selective electrodes (ISEs). Silver microparticles were characterized by high-resolution scanning electron microscopy and X-ray photoelectron spectroscopy, while the presence of AgCl and AgBr on Ag-MPs was determined by microanalysis. We analyzed the influence of operational variables, including: hydrogen peroxide concentration in Ag-MP system, medium pH, influence of Cl- ions on Br- ion removal, and influence of tannic acid as surrogate of organic matter in the medium. Regarding the influence of pH, Br-and Cl- removal was constant within the pH range studied (3.5-7), being more effective for Br- than for Cl- ions. Accordingly, this research states that the system Ag-MPs/H2O2 can remove up to 67.01% of Br- ions and 56.92% of Cl- ions from water (pH = 7, [Ag-MPs]0 = 100 mg L-1, [H2O2]0 = 0.2 mM); it is reusable, regenerated by radiation and can be easily removed by applying a magnetically assisted chemical separation process.

Clinical practice update of antifungal prophylaxis in immunocompromised children.

Due to the rise in the number and types of immunosuppressed patients, invasive fungal infections (IFI) are an increasing and major cause of morbidity and mortality in immunocompromised adults and children. There is a broad group of pediatric patients at risk for IFI in whom primary and/or secondary antifungal prophylaxis (AFP) should be considered despite scant evidence. Pediatric groups at risk for IFI includes extremely premature infants in some settings, while in high-risk children with cancer receiving chemotherapy or undergoing haematopoietic stem cell transplantation (HCT), AFP against yeast and moulds is usually recommended. For solid organ transplanted, children, prophylaxis depends on the type of transplant and associated risk factors. In children with primary or acquired immunodeficiency such as HIV or long-term immunosuppressive treatment, AFP depends on the type of immunodeficiency and the degree of immunosuppression. Chronic granulomatous disease is associated with a particular high-risk of IFI and anti-mould prophylaxis is always indicated. In contrast, AFP is not generally recommended in children with long stay in intensive care units. The choice of AFP is limited by the approval of antifungal agents in different age groups and by their pharmacokinetics characteristics. This document aims to review current available information on AFP in children and to provide a comprehensive proposal for each type of patient.