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This work aims to integrate several hydrogen peroxide (H2O2) activation mechanisms, photolysis (UVC irradiation), chemical electron transfer (TiO2-P25 photocatalysis), and reaction with TiO2-P25 in dark conditions, for reactive oxygen species (ROS) generation towards the removal of contaminants of emerging concern (CECs), in a single unit operated in continuous-flow mode. An H2O2 stock solution is fed by the lumen side of a tubular ceramic membrane, delivering the oxidant to the (i) catalyst immobilized in the membrane shell-side and (ii) annular reaction zone (ARZ, space between membrane shell-side and outer quartz tube) where CECs contaminated water flows with a helix trajectory, being activated by UV light provided by four lamps placed symmetrically around the reactor. First, the effect of several parameters in the removal of a CEC target molecule, amoxicillin (AMX), was evaluated using a synthetic solution ([AMX]inlet = 2.0 mg L-1): (i) light source (UVA or UVC radiation), (ii) H2O2 dose, (iii) H2O2 injection method (radial permeation vs. upstream injection), and (iv) number of TiO2-P25 layers deposited on the membrane. The UVC/H2O2/TiO2 system with radial addition of H2O2 (20 mg L-1) and 9-TiO2-P25 layers provided the highest AMX removal efficiency (72.2 ± 0.5%) with a UV fluence of 45 mJ cm-2 (residence time of 4.6 s), due to the synergic effect of four mechanisms: (i) AMX photolysis, (ii) H2O2 photocleavage, (iii) TiO2-P25 photoactivation, and (iv) chemical reactions between H2O2 and TiO2-P25. The urban wastewater matrix showed a negative effect on AMX removal (~44%) due to the presence of ROS scavengers and light-filtering species. [ABSTRACT FROM AUTHOR]

Introducción: Las inmunodeficiencias primarias son un grupo heterogéneo de trastornos genéticos que afectan el funcionamiento del sistema inmunológico. Pueden presentarse con características clínicas variables en la primera infancia y en la edad adulta. Objetivo: Caracterizar clínica y demográficamente a pacientes diagnosticados con inmunodeficiencias primarias. Métodos: Se realizó un estudio de serie de casos, transversal, descriptivo, retrospectivo, con 39 pacientes de ambos sexos, con diagnóstico de inmunodeficiencias primarias, según la última clasificación de la International Union of Immunological Societies; atendidos de enero de 2012 a diciembre de 2021 en Granma. Se evaluó la edad (de inicio de los síntomas, diagnóstico y retraso en el diagnóstico), sexo, antecedentes familiares y manifestaciones clínicas. Se recolectaron los datos de las historias clínicas. Se utilizó estadística descriptiva. Resultados: La edad de inicio de los síntomas osciló entre el mes de vida y los 37 años, con una media de 6,31 años; la edad media de diagnóstico fue de 11,89 años. Las deficiencias humorales representaron el 69,23 % de todas las inmunodeficiencias primarias y predominó el déficit relativo de IgA (11 casos). Reportaron antecedentes familiares de inmunodeficiencias primarias 12 pacientes. Las infecciones recurrentes (71,79 %) y las alergias (61,53 %) fueron las manifestaciones más frecuentes; la tasa de mortalidad fue de 2,56 %. Conclusiones: Las inmunodeficiencias primarias fueron más frecuentes en la infancia, con el mismo comportamiento en ambos sexos. Las infecciones, las alergias y los antecedentes familiares de inmunodeficiencia primaria fueron hallazgos importantes. Las inmunodeficiencias humorales fueron las más prevalentes.

Background: the torpid progress of chronic eye disorders, with conventional treatments, impels the alternative use of immunomodulators.Objective: to describe the use of immunomodulators in patients with chronic eye disorders that do not improve with conventional treatments, attended to at the department of immunoallergy of the Clinic of Medical Specialties of Granma, from 2017 through 2020.Methods: a descriptive study was carried out at the aforementioned clinic and during the period herein declared. Out of a universe of 101 patients, older than 18 years, 96 were chosen by intentional sampling who consented to be treated with immunomodulators, from January 2017 through December 2018, with follow-ups of at least two-year duration. The effectiveness of immunomodulators on keratitis and uveitis was studied. The following drugs were used: Hebertrans, human gamma globulins at 10 % and the combination of this with levamisole or Hebertrans.Results: treatments were effective in 89,58 % of overall cases, reaching 92,86 % in posterior uveitis. Ten patients could not be controlled, half of them with herpetic keratitis. 61,46 % were treated with Hebertrans, which was effective in 89,83 %. 87,46 % of the patients with herpetic keratitis were controlled with Hebertrans and 90,91 % of the patients suffering from uveitis with human gamma globulins.Conclusions: the use of immunomodulators in patients with chronic eye disorders was described. Hebertrans, single gamma globulin or its combinations were effective.

Abstract A correlative approach employing optical microscopy and scanning electron microscopy is proposed for the quantification of phases and pores in iron ore pellets. Combining mosaic images covering the full cross-sections of pellets, obtained with both techniques, it is possible to improve the discrimination of pores, quartz and silicates. First, the images must be carefully registered to show the exact same regions. The procedure for registration, discrimination and quantification was developed with Fiji open source software. A qualitative and quantitative analysis confirmed the advantages of the correlative method as compared to the individual techniques.

Ca 2+ signal-generation through inter-membrane junctional coupling between endoplasmic reticulum (ER) STIM proteins and plasma membrane (PM) Orai channels, remains a vital but undefined mechanism. We identify two unusual overlapping Phe-His aromatic pairs within the STIM1 apical helix, one of which (F394-H398) mediates important control over Orai1-STIM1 coupling. In resting STIM1, this locus is deeply clamped within the folded STIM1-CC1 helices, likely near to the ER surface. The clamped environment in holo-STIM1 is critical-positive charge replacing Phe-394 constitutively unclamps STIM1, mimicking store-depletion, negative charge irreversibly locks the clamped-state. In store-activated, unclamped STIM1, Phe-394 mediates binding to the Orai1 channel, but His-398 is indispensable for transducing STIM1-binding into Orai1 channel-gating, and is spatially aligned with Phe-394 in the exposed Sα2 helical apex. Thus, the Phe-His locus traverses between ER and PM surfaces and is decisive in the two critical STIM1 functions-unclamping to activate STIM1, and conformational-coupling to gate the Orai1 channel., (© 2023. The Author(s).)

Case Presentation: A 68-year-old male patient underwent a resection of a DDL (T2 N0 M0, FNCLCC grade 2, stage IIIA) in the retroperitoneum. Three months after this first surgery, a recurrence occurred, and was treated with neoadjuvant and adjuvant doxorubicin plus ifosfamide and surgery (resection). A second recurrence-11 months after the second surgery-was treated with surgery and radiotherapy. The patient then began to undergo VAE treatment (0.2 mg-2 mg, subcutaneously, thrice a week). After the VAE treatment was initiated, the patient reported improved quality of life. A third recurrence-12 months after the third surgery-was treated with surgery, radiotherapy, and with an increased dose of VAE (20 mg). Sixty-nine months (5.8 years) after the fourth surgery a fourth recurrence occurred. It was again treated with surgery, along with a month of intravenous VAE infusions and subsequent subcutaneous VAE (20 mg) treatment. Finally, a fifth recurrence-5 months after the fifth surgery-was treated with subcutaneous and intravenous VAE applications and eribulin. The patient died 11 months after the last recurrence; he received a total of 103 months (8.6 years) of VAE treatment and achieved 10.5 years of survival., Conclusion: The case presented herein shows a long-time survival and a prolonged recurrence-free interval in a patient with retroperitoneal DDL treated with surgery, chemotherapy, radiotherapy, and VAE injections. On the basis of the antitumoral and immunomodulating effects of VAE and on the reported prolonged survival of VAE-treated patients with other types of tumors, the adjunct VAE treatment is presumed to have contributed to the favorable outcome. Regarding the clinical relevance of VAE treatment, further investigations are needed.

Rationale: Thymic neuroendocrine tumor (TNET) is very rare and characterized by a tendency to invade adjacent structures, frequent metastasis, resistance to therapy, and a poor prognosis. Viscum album extracts (VAE) have shown immunological, apoptogenic, and cytotoxic properties., Patient Concerns: A 54-year-old Peruvian man was suffering from constant fatigue, cough, dyspnea, and fever for a couple of months., Diagnoses: He was diagnosed with TNET (12.8 cm × 10 cm × 7 cm) stage IIIa, G1. Due to the size and extensive invasiveness (vena cava superior, also obstructing 85% of its lumen, pericardium, and pleura), the TNET was inoperable., Interventions: We report the case of this patient who declined chemotherapy and was treated instead with sole subcutaneous VAE 3 times per week for 85 months. No other tumor-specific intervention was applied., Outcomes: Quality of life (QoL) improved substantially. The patient returned to work, and the tumor remained stable for 71 months. Thereafter, the tumor progressed, and the patient died 90 months after initial diagnosis. Besides self-limited local skin reactions around the application site, no side effects occurred., Lessons: This is an exceptionally good course of disease of an inoperable, large, obstructing, and invasive TNET with a reduced baseline condition (Karnofsky index: 50-60) due to pronounced symptoms. Given the considerable reduction of symptoms and improved QoL following the onset of VAE therapy and other reports describing long disease stability and improvement of the QoL using VAE in different cancer types, we presume that the VAE treatment was supportive in this case. As TNETs are rare and few trials are available, future treatments of TNETs using VAE should be carefully documented and published to help determine whether further investigation of the use of VAE in TNET treatment is worthwhile.

Background: Bilateral asynchronous renal cell carcinoma (RCC) is infrequent. Immunotherapy is the first-line treatment for advanced RCC not controlled by locoregional therapy. Viscum album extracts (VAE) have been shown to improve quality of life as well as immunological and antineoplastic properties in different types of cancers., Case Report: A 67-year-old man was diagnosed with Fuhrman grade 3/4 RCC, stage pT1bN0M0 in the right kidney. During the subsequent 6 years, he underwent a right nephrectomy and two metastasectomies (lung). Then an RCC lesion of the left kidney was detected. The patient refused a second nephrectomy and was treated solely with high-dose intravenous and subsequent subcutaneous VAE. A central necrotic area and a peritumoral halo were seen on an ultrasound follow-up from month 7. The patient showed no further progression of RCC during the next 2.5 years., Conclusion: As far as we are aware of, this is the first report of a patient with metastatic RCC with an RCC lesion of the second kidney treated solely with high-dose intravenous and subcutaneous VAE, associated with 2.5 years of progression-free survival and a good quality of life. The use of VAE in RCC should be carefully documented and published to determine future research., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Rationale: Carcinoma in situ (CIS) of the uterine cervix is a premalignant condition of squamous epithelium. The standard treatments are excision and ablation procedures; for women with positive margins, hysterectomy is recommended., Patient Concerns: A 47-year-old Peruvian woman with recurrent candidal vaginitis had been diagnosed with colpocervicitis and squamous metaplasia 8 years ago, which were not treated., Diagnoses: The patient was diagnosed with CIS after cervical conization procedure. She refused radical hysterectomy and opted for integrative medicine treatment., Interventions: She was treated with intralesional and subcutaneous Viscum album L. extract (VAE) injections. VAE is a widely used herbal cancer treatment with cytotoxic, apoptogenic, and immunological effects, but it has not been investigated in cervical CIS., Outcomes: Ending month 5 of treatment, complete remission of cervical CIS was observed. The patient is still in remission after 30 months (until publication)., Lessons: This is the first report on complete remission of cervical CIS after intralesional and subcutaneous injection with VAE. Prospective studies should evaluate to what degree the treatment effect is reproducible.

Objectives: The aim of this study was to evaluate whether pancreatic necrosis with presence of gas is an absolute indication for surgery or if there is a possibility for the medical management of this pathology., Methods: This study is a retrospective study including 56 patients with diagnosis of pancreatic necrosis and gas on computed tomography from April 2003 to March 2011. We recorded all the factors related to each group of treatment, including APACHE II score, C-reactive protein level, Tomographic Severity Index, organ and multiorgan failure, and infected necrosis after fine-needle puncture, to evaluate the differences between surgical and medical treatment., Results: Thirty-six (64%) of these patients were submitted to surgery, whereas 20 (36%) were managed conservatively. Twenty-eight patients (78%) who underwent surgery had infected necrosis. Thirty-five percent of the patients (7 patients) in the medical group had organ failure versus 83% of the patients in the surgical group., Conclusions: Pancreatic necrosis with gas on computed tomography is a relative indication for surgery. Medical management is a feasible and safe possibility for this pathology in selected cases. The presence of organ failure and infected necrosis often precludes a surgical treatment.

Unlabelled: Formerly an infrequent pathology, pancreatic cystic tumors stand nowadays for 25% of all pancreatic surgical diseases., Objective: Evaluate the frequency of the presentation of each type and the behavior of the pancreatic cystic tumors that went to surgery in our unit., Materials and Methods: In our Pancreas Unit, 708 patients with pancreatic tumors underwent surgery in the period between October 2002 and December 2013. 146 cases of pancreatic cystic tumors taken from that group are the topic of the present study., Results: Even when diagnosing pancreatic tumors as cystic tumors was possible in 91% of cases during pre-op evaluation, categorizing the type of cystic tumor was only possible in 73% of cases. In 128 cases (88%), cystic tumors were removable. Due to advanced disease, in 3 cases only diversion surgery was possible and, in 15 cases, exploration and biopsy was the only choice. When the frequency of malignancy was assessed for all four types of pancreatic cystic tumors, the one most frequently becoming malignant was mucinous papillary intraductal (53%), followed by mucinous cystic (50%). Solid pseudopapillary pancreatic cystic tumors became malignant in 29% of cases and for serous cystoadenoma the frequency of malignancy was nihil., Conclusions: Cystic tumors are the most frequent type of pancreatic lesion. It's of paramount importance to categotize them since risk of malignancy can be as high as 52% in case of mucinous intraductal papillary type.