Upconversion emission obtained in Yb(3+)-Er(3+) doped fluoroindate glasses using silica microspheres as focusing lens.

An intensity enhancement of the green upconversion emission from a codoped Er(3+)-Yb(3+) fluoroindate glass has been obtained by coating the glass surface with silica microspheres (3.8 µm diameter). The microspheres focus an incoming beam (λ ≈ 950 nm) on the surface of the fluoroindate glass. The green emission (λ ≈ 545 nm) of the Er(3+) ions located in the microsphere focus was measured with a microscope in reflection mode, being the peak intensity 4.5 times the emission of the bare substrate. The transversal FWHM of the upconversion spot was experimentally determined by deconvolution with the experimental Point Spread Function of the system, obtaining a value of 309 nm. This value is in good agreement with Finite-Difference Time-Domain simulations taking into account the magnification of the image due to the microsphere.

Whispering-gallery modes in glass microspheres: optimization of pumping in a modified confocal microscope.

Whispering-gallery modes (WGMs) on Nd3+-doped glass microspheres with a radius of ∼15 µm were measured in a modified confocal microscope, where a dual spatial resolution in both excitation and detection zones was possible. As an alternative to the standard excitation mechanism by an evanescent wave, we used an efficient pumping/detecting scheme, focusing a laser in the microsphere and exciting the Nd3+ ions, whose fluorescent emission produces the WGMs. We have also measured the generated WGMs by changing the detection zone, where higher amplitude resonances were found when exciting in the center and detecting at the edge of the microsphere.

[Burden of disease due to bacterial meningitis, Cuba 2006]. / Carga de enfermedad por meningitis bacteriana, Cuba 2006.

INTRODUCTION: bacterial meningitis is a real concern for physicians and general health systems of any country as well as the international bodies. OBJECTIVE: to estimate burdens of disease from morbidity and mortality caused by bacterial meningitis in Cuba during 2006. METHODS: the mortality and the incidence data of the epidemiological survey from the National Surveillance of Bacterial Meningitis of "Pedro Kourí Institute of Tropical Medicine were used. The estimation methods were based on the WHO recommendations by using the DISMOD and the required Excel spreadsheets. RESULTS: the global burden of bacterial meningitis was estimated at a total of 3527.26 Disability Adjusted Lost Years (DALYs), which accounted for 31.3 years lost per 100 000 inhabitants. Morbidity and mortality burden of bacterial meningitis without sequel weighing was 2056.25 disability adjusted lost years, being the 55.9 % caused by unidentified agent, followed by S. pneumoniae (30.9 %), N. meningitidis (9.5 %) and H influenza type b (3.6 %). The mortality burden was 2 039 years of life lost from premature death, that is, 57.8 % of the global burden. Children under five years of age contributed the biggest global burden of disability adjusted lost years, and S. penumoniae generated the biggest burden. CONCLUSION: the burden of bacterial meningitis was high. Burden of disease is an important measure to assess health problems.

Whispering gallery modes in a glass microsphere as a function of temperature.

Microspheres of Nd3+ doped barium titano silicate glass were prepared and the whispering gallery mode resonances were observed in a modified confocal microscope. A bulk sample of the same glass was calibrated as temperature sensor by the fluorescence intensity ratio technique. After that, the microsphere was heated by laser irradiation process technique in the microscope and the surface temperature was estimated using the fluorescence intensity ratio. This temperature is correlated with the displacement of the whispering gallery mode peaks, showing an average red-shift of 10 pm/K in a wide range of surface temperatures varying from 300 K to 950K. The limit of resolution in temperature was estimated for the fluorescence intensity ratio and the whispering gallery mode displacement, showing an improvement of an order of magnitude for the second method.

Tratamiento de la enfermedad de Cushing con ketoconazol / Treatment of Cushing's disease with ketoconazole

La enfermedad de Cushing (EC), debida fundamentalmente a un microadenoma hipofisario, es un cuadro clínico poco frecuente en la edad pediátrica y se asocia a una significativa morbilidad. La principal indicación terapéutica es la cirugía transesfenoidal, aunque se reserva el ketoconazol como alternativa terapéutica temporal durante el período de espera previo, a fin de controlar el hipercortisolismo. A continuación se presenta el caso de una niña de 13 años y 8 meses con EC. Sus manifestaciones clínicas eran obesidad, disminución de la velocidad del crecimiento, fenotipo cushingoide, cefaleas e hipertensión arterial. Las determinaciones hormonales pusieron de manifiesto valores elevados de cortisol libre urinario y de corticotropina (ACTH). El ritmo de cortisol y de ACTH así como el test corto y largo de dexametasona confirmaron un hipercortisolismo dependiente de ACTH. La resonancia magnética craneal con gadolinio mostró la presencia de microadenoma en hemiadenohipófisis derecha. El diagnóstico se confirmó tras realizar un cateterismo selectivo de senos petrosos inferiores con estímulo de corticoliberina. En espera de cirugía transesfenoidal, el tratamiento con ketoconazol (200mg/24h) durante 6 meses controló el cuadro de hipercortisolismo. Tras la adenomectomía transesfenoidal, recibió tratamiento sustitutivo con hidrocortisona durante un mes. En la actualidad, la niña lleva 2 años y medio en remisión clínica y hormonal sin cumplir los criterios iniciales posquirúrgicos de curación (AU)

Cushing’s disease (CD), which is caused fundamentally by a pituitary microadenoma, is a rare endocrine disease in the paediatric age and which is associated with significant morbidity. The current treatment of choice for CD is trans-sphenoidal selective adenomectomy resulting in long-term remission rates. Pharmacological management of CD is directed at decreasing adrenal steroid secretion. Ketoconazole inhibits adrenal enzyme activity and decreases cortisol secretion. Our patient is a girl of 13 years and eight months of age with CD. The clinical manifestations were obesity, decrease in growth rate, Cushingoid phenotype, headache and arterial hypertension. The hormone determinations showed elevated values of UFC and ACTH. The circadian rhythm cortisol and ACTH and the short and long dexamethasone tests of provide definitive diagnosis of CD. The cranial MRI with gadolinium suggests the presence of microadenoma in the right pituitary lobe. The diagnosis is confirmed after performing a selective catheterisation of the inferior petrosal sinuses with CRH stimulus. While waiting for trans-sphenoidal surgery, the treatment with ketoconazole (200mg/24h) controlled the hypercortisolism. After the surgical procedure, the patient received replacement therapy with hydrocortisone for 1 month. At the present time, the patient, without fulfilling the post surgery cure criteria, has been 2 and a half years in clinical and hormonal remission (AU)

[Treatment of Cushing's disease with ketoconazole]. / Tratamiento de la enfermedad de Cushing con ketoconazol.

Cushing's disease (CD), which is caused fundamentally by a pituitary microadenoma, is a rare endocrine disease in the paediatric age and which is associated with significant morbidity. The current treatment of choice for CD is trans-sphenoidal selective adenomectomy resulting in long-term remission rates. Pharmacological management of CD is directed at decreasing adrenal steroid secretion. Ketoconazole inhibits adrenal enzyme activity and decreases cortisol secretion. Our patient is a girl of 13 years and eight months of age with CD. The clinical manifestations were obesity, decrease in growth rate, Cushingoid phenotype, headache and arterial hypertension. The hormone determinations showed elevated values of UFC and ACTH. The circadian rhythm cortisol and ACTH and the short and long dexamethasone tests of provide definitive diagnosis of CD. The cranial MRI with gadolinium suggests the presence of microadenoma in the right pituitary lobe. The diagnosis is confirmed after performing a selective catheterisation of the inferior petrosal sinuses with CRH stimulus. While waiting for trans-sphenoidal surgery, the treatment with ketoconazole (200mg/24h) controlled the hypercortisolism. After the surgical procedure, the patient received replacement therapy with hydrocortisone for 1 month. At the present time, the patient, without fulfilling the post surgery cure criteria, has been 2 and a half years in clinical and hormonal remission.

La prevención de las drogodependencias en las escuelas promotoras de salud* / The prevention of drug in the European health promoting schools

Objetivo: la Escuela Promotora de Salud se basa en un modelo social de salud que hace hincapié tanto sobre la organización global de la escuela como sobre el aspecto individual. En el núcleo de este modelo está el joven, considerado como una persona integral que evoluciona en un entorno dinámico. Material y métodos: el currículum de la Escuela promotora de Salud proporciona a los y las jóvenes oportunidades para aprender y comprender, así como para adquirir hábitos esenciales de vida. El currículum debe adaptarse a las necesidades, tanto actuales como futuras, de los jóvenes, impulsar su creatividad, estimularles a aprender y dotarlos de las aptitudes necesarias para este aprendizaje. Resultados: la Red Europea de Escuelas promotoras de Salud ha puesto de manifiesto que la plena implantación de políticas, principios y métodos de la escuela promotora de salud puede contribuir de modo significativo a la experiencia educativa de todos los jóvenes que aprenden en ellas. La escuela promotora de salud constituye una inversión en ambos casos: educación y salud. Conclusiones: el enfoque de una Escuela promotora de Salud da lugar a la creación de un marco social muy favorable que influye en las ideas, percepciones y acciones de todos los que viven, trabajan, participan y aprenden en la escuela. Dicho marco genera un clima positivo que influye en la forma de establecer relaciones y en la toma de decisiones que afectan a los y las jóvenes, así como en el modelo en que ellos y ellas desarrollan sus valores y actitudes. A la luz de los datos disponibles, podemos afirmar que los elementos que determinan la educación y la salud están inseparablemente unidos. Existe una dinámica que no podemos ignorar a la hora de trabajar, si queremos proteger, apoyar y potenciar la educación y la salud de nuestros jóvenes. (AU)

Cuerpo extrano en la fosa posterior del craneo. Informe de un caso. / Foreign body in posterior cranial fossa. Report of a case

Se informa un caso de penetracion de una aguja de coser a la fosa posterior del craneo. La aguja penetro en el bulbo raquideo por debajo del obex, y producia parestesias en los cuatro miembros cuando la paciente tratada de mover la cabeza. Se describen los intentos de extraccion de la aguja y se hace hincapie en que el tratamiento quirurgico debe ser con exposicion amplia para evitar lesion de las estructuras nerviosas