Multi-octave mid-infrared supercontinuum generation in tapered chalcogenide-glass rods.

We report on the experimental development of short-tapered chalcogenide-glass rods for mid-infrared supercontinuum generation. Multi-octave spectral broadening of femtosecond laser pulses is demonstrated from 1.6 to 15.6 µm in a 5-cm-long tapered Ge20Se70Te10 rod with a waist diameter of 25 µm. Despite the multimode nature of the optical waveguide used, this work clearly shows the potential of such simple post-processed rods for advancing fiber SC sources with infrared glasses, thereby unlocking new possibilities in terms of coupling efficiency, spectral coverage, and output power.

Cadaveric Identification through Macroscopic Analysis of Dental Implants Subjected to High Temperatures-An Experimental Model.

The aim of this study was to determine the possibility of identifying a dental implant through the measurement of the apical width and the interspiral distance in a periapical radiograph after being subjected to high temperatures for certain lengths of time. In total, 11 fresh human anatomical models were selected, in which 137 implants were placed. Previous periapical radiographs were performed using parallelizers in each implant. Subsequently, the anatomical models were introduced into a crematory oven at different temperatures and for various durations: 500 °C/15 min, 500 °C/30 min, 700 °C/15 min, 800 °C/15 min, 800 °C/45 min, 500 °C/15 min, 700 °C/15 min, and finally, 1000 °C/120 min. After this, X-rays were taken via a parallel technique, and the apical width and interspiral distance were measured. The implants were disinserted, and the coronal width was used to calculate magnification or possible distortion. All data were analyzed by the Mann-Whitney U test. There were no statistically significant differences for the apical width parameter, except when the temperature was raised to 700 °C/15 min and to 800 °C/45 min. For the interspiral distance parameter, there were no statistically significant differences, except when the implants were subjected to 800 °C/15 min and 1000 °C/120 min. It was determined that there were changes in some groups based on the increase in temperature and exposure time. Neither of the two parameters were completely useful for the identification because some of the groups studied in both variables presented differences, which makes them difficult to identify correctly.

Case Report: Successful Treatment with Miltefosine of Severe New World Mucosal Leishmaniasis Caused by Leishmania guyanensis.

An 88-year-old man with mutilating mucosal leishmaniasis (ML) involving septal perforation, with granulomas in the pharynx and larynx, was treated with oral miltefosine, 50 mg three times/day for 28 days. Miltefosine, an antineoplastic agent, is considered an alternative option for the treatment of ML, showing efficacies of 75-92% in Bolivia, Brazil, and Argentina. The patient denied having previous cutaneous (CL) leishmaniasis, and no CL lesions were recognized by physical examination. Parasites obtained from mucosal lesions were identified by cytochrome b gene sequencing as Leishmania guyanensis. Clinical cure was observed 2 months posttreatment, and no evidence of reactivation was observed in the 3-year follow-up. Adverse effects such as nausea, loss of appetite, and epigastric pain were experienced during treatment with miltefosine. There is a need for improved access to miltefosine in leishmaniasis-endemic areas of Latin America and a greater awareness of ML and its treatment among physicians working in endemic countries.

Technology validation of photosynthetic biogas upgrading in a semi-industrial scale algal-bacterial photobioreactor.

The performance of photosynthetic biogas upgrading coupled to wastewater treatment was evaluated in an outdoors high rate algal pond (HRAP) interconnected to an absorption column at semi-industrial scale. The influence of biogas flowrate (274, 370 and 459 L h-1), liquid to biogas ratio (L/G = 1.2, 2.1 and 3.5), type of wastewater (domestic versus centrate) and hydraulic retention time in the HRAP (HRT) on the quality of the biomethane produced was assessed. The highest CO2 and H2S removal efficiencies (REs) were recorded at the largest L/G due to the higher biogas-liquid mass transfer at increasing liquid flowrates. No significant influence of the biogas flowrate on process performance was observed, while the type of wastewater was identified as a key operational parameter. CO2 and H2S-REs of 99% and 100% at a L/Gmax = 3.5 were recorded using centrate. The maximum CH4 content in the biomethane (90%) was limited by N2 and O2 desorption.

Infecciones en pacientes con trauma craneoencefálico en el Servicio de Politrauma: Camagüey 2013-2015 / Infections in patients with traumatic brain injury in Polytrauma Service: Camagüey 2013-2015

Fundamento: las infecciones nosocomiales o en su concepto más amplio las infecciones relacionadas con el cuidado sanitario, constituyen en la actualidad uno de los principales problemas en las unidades de cuidados intensivos. Existen varios factores que contribuyen al desarrollo de estas en los pacientes con trauma craneoencefálico, que favorecen el desarrollo de una lesión cerebral secundaria durante su período postraumático y se correlacionan con la duplicación de la mortalidad. Objetivo: caracterizar las infecciones en los pacientes con trauma craneoencefálico. Métodos: se realizó un estudio descriptivo transversal en pacientes hospitalizados en el servicio de Politrauma del Hospital Universitario Manuel Ascunce Domenech de Camagüey, desde enero 2013 hasta diciembre 2015. La población en estudio estuvo constituida por los 64 pacientes ingresados con el diagnóstico de trauma craneoencefálico, en quienes se aisló un microorganismo patógeno. Las variables estudiadas fueron: grupos de edades, sexo, necesidad de ventilación mecánica artificial, estado al egreso, estadía, microorganismos patógenos aislados y sus localizaciones. Resultados: la mayor frecuencia de los pacientes correspondió al sexo masculino y en edades entre los 48-57 años. Casi la totalidad de los comprendidos en edades entre los 48 y 57 años necesitaron ventilación mecánica artificial y fallecieron más de un tercio. Se presentaron en mayor proporción la estadía de 21 y más días, entre los microorganismos aislados el acinetobacter spp y entre las localizaciones de las infecciones adquiridas, la neumonía asociada a la ventilación mecánica artificial y la bacteriemia por catéter. Conclusiones: predominaron los pacientes del sexo masculino y del grupo de edades de 48 a 57 años, el acinetobacter spp como microorganismo aislado y la neumonía asociada a la ventilación mecánica artificial, así como la bacteriemia por catéter.

Background: nosocomial infections or in its broadest concept hospital-acquired infections, are now one of the main problems in intensive care units, there are several factors contributing to the development of these infections in patients with traumatic brain injury, favoring the development of secondary brain injury during the post-traumatic period, correlating this event with the doubling of mortality rate. Objective: To characterize of nosocomial infections in patients with traumatic brain injury. Methods: a descriptive transversal study was conducted in hospitalized patients in the Polytrauma Service of the University Hospital of Camagüey Manuel Ascunce Domenech, during the period January 2013 to December 2015. The study group consisted of 64 patients admitted with the diagnosis traumatic brain injury which a pathogenic microorganism was isolated. Studied variables: age groups, gender, need for artificial mechanical ventilation, discharge status, stay, isolated pathogenic microorganisms and their localizations. Results: the highest frequency of patients belonged to male who aged between 48-57 years. Almost all of them aged between 48 and 57 years old needed artificial mechanical ventilation, and more than one third died, the stay was presented a higher frequency in patients with 21 or more days in hospital, the most frequent isolated microorganism the acinetobacter spp, and locations of the most frequent infections were the pneumonia associated to mechanical ventilation artificially and catheter bacteremia. Conclusions: there was a prevalence of male patients corresponding to the age group from 48-57 years old. The most frequent findings were the acinetobacter spp as isolated microorganism and pneumonia associated to artificial mechanical ventilation as well as catheter bacteremia.

Algunos aspectos clínicos y espirométricos en la enfermedad pulmonar obstructiva crónica / Some clinical and spirometric aspects of the chronic obstructive pulmonary disease

Fundamento: La enfermedad pulmonar obstructiva crónica (EPOC) es una de las afecciones respiratorias de evolución lenta y progresiva, que tiene mayor frecuencia y gravedad. Objetivo: Analizar algunos aspectos clínicos y espirométricos de la enfermedad pulmonar obstructiva crónica. Método: Se realizó un estudio sobre algunos aspectos clínicos y espirométricos en pacientes portadores de enfermedad pulmonar obstructiva crónica atendidos en el servicio de Neumología del Hospital Provincial Docente Manuel Ascunce Domenech de Camagüey en el año 2006. El universo estuvo constituido por 172 pacientes. El análisis de los datos se realizó mediante estadística descriptiva con el método Microstat. Resultados: La enfermedad prevaleció en el grupo de personas de más de 50 años de edad, 92 (53 por ciento) y el sexo más afectado fue el masculino con 110 casos (64 por ciento). El tabaquismo se demostró en el 72 por ciento La complicación más frecuente fue la recurrencia de infecciones del tracto respiratorio 114 (66 por ciento). Conclusiones: Predominaron los pacientes con obstrucción moderada de las vías aéreas 60 (35 por ciento), seguida de la obstrucción mixta con 55 enfermos para el 32 por ciento.

Background: Chronic obstructive pulmonary disease (EPOC) is one of the respiratory affections of progressive and slow evolution, that has greater frequency and gravity. Objective: To analyze some clinical and spirometric aspects of the chronic obstructive pulmonary disease. Method: A study on some clinical and spirometric aspects was performed in patient carriers of chronic obstructive pulmonary disease attended in the Pneumology service at Manuel Ascunce Domenech Educational Provincial Hospital of Camagüey in the year 2006. The universe was constituted by 172 patients. Data analysis was carried out by means of descriptive statistics with Microstat method. Results: The disease prevailed in the group of people older than 50-year-old, 92 (53 percent) and the most affected sex was the male one with 110 cases (64 percent). Tabacism was shown in the 72 percent. The most frequent complication was the infections recurrence of the respiratory tract 114 (66 percent). Conclusions: Patients with moderate obstruction of the airway 60 (35 percent), followed by mixed obstruction with 55 sickpeople for the 32 percent predominated.

Enfermedad de hddgkin primitiva de mediastino: reporte de un caso / Primitive Hodgkin´s disease of mediastinum: Acase report

Se presenta el caso de una paciente blanca de 62 años de edad con hipertensión arterial que acude al hospital por presentar desde hace tres meses disfonía, dolor interno al levantar el brazo derecho y disfagia ligera. Se le realizaron estudios hematológicos, radiológicos e histológicos que permitieron arribar al diagnóstico de enfermedad de Hodgkin celularidad mixta primitiva del mediastino. Los estudios radiológicos e histológicos fueron los más utilizados. El tratamiento de radioterapia y quimioterapia combinado resultó favorable. Se comenta el cuadro clínico, su diagnóstico, tratamiento y se revisa la literatura.

A case of a white 62-years-old patient with arterial hypertension is presented that come up to the hospital by presenting dysphonia since three months ago, internal pain at raising the right arm and mild dysphagia. Hematologic, radiologic, and histological studies were perfomed, that permitted diagnose Hodgkin´s disease primitive mixed cellularity of the mediastinum. The radiological and histological studies were the most utilized. Combined treatment of radiation therapy and chemotherapy turned out to be favorable. Clinical picture, its diagnosis, and treatment are commented also the literature is reviewed.

Meningoencefaliiis en el curso de un herpes zóster facial / Meningoencephalitis in the course of an herpes zoster facialis

La infección por el virus varicela zóster como causa de meningoencefalitis es infrecuente, especialmente si el paciente es inmunocompetente. Se presenta un caso de paciente mestizo, de 42 años, profesor de Educación Física, con cuadro de herpes zóster facial, con intenso dolor, lesiones eritematosas con vesículas que afectan la parte izquierda de la nariz, párpado y ojo izquierdo, así como la hemifrente del mismo lado, fiebre de 39- 40oc, desorientación, rigidez de nuca, vómitos intensos en proyectil. Se realiza punción lumbar, la cual resulta francamente patológica. Se impone tratamiento con Aciclovir, Inmunomoduladores, Neuroprotectores y Vitaminoterapia, se obtiene resolución del cuadro neurológico, dermatológico y oftalmológico. Se comenta el cuadro clínico, su diagnóstico y se revisa la literatura.

The infection by the varicella-zoster virus as cause of meningoencephalitis is infrequent, especially if the patient is immunocompetent. A case of a 42 years-old, mixed race patient is presented, Physical Education professor, with a picture of herpes zoster facialis, intense pain, erythematous lesions with vesicles that affect the left side of the nose, eyelid and left eye, as well as the hemiforhead of the same side, fever about 39- 40oc, disorientation, inflexibility of the nape, intense projectile vomitings. Lumbar puncture is carried out, which turns out to be pathological. Treatment with acyclovir, immunomodulators, neuroprotectors and vitaminotherapy, is imposed, resolution of the dermatological, neurological and ophthalmological picture, was obtained. The clinical chart, and its diagnosis is commented and the literature is revised.

Quimioradioterpiia en el cáncer de arringe / Quemoradiotherapy in the larynx cancer

Se realizó un estudio explicativo para conocer las principales características clínicas y anatomopatológicas de las lesiones de pacientes tratados con quimioterapia y radioterapia con diagnóstico inicial de cáncer de laringe, clasificados según TNM y se evaluó la respuesta al tratamiento. Se revisaron los expedientes clínicos de 55 pacientes tratados en el Instituto Nacional de Oncología de La Habana desde el año 1996 hasta el 2005. Predominaron los de 61 y 70 años, 25 (45.45 %) y los de 51 y 60 años, 15 (27.27 %). La laringe glótica fue la ubicación topográfica más frecuente con 28 pacientes (50.9 %). Se obtuvieron respuestas objetivas en el 94.54 % de los mismos, el 4.5 % conservaron su laringe, en la mayor parte de éstos se obtuvieron respuestas, la respuesta completa fue evidente en 36 (65.45 %) y la parcial en 16 (29.09 %).

An explanatory study was carried out to know the main clinical and anatomicopathological characteristics of the lesions of patients treated with chemotherapy and radiation therapy with initial diagnosis of larynx cancer, classified according to TNM and the response to the treatment, was evaluated. The clinical recording of 55 treated patients in the National Institute of Oncology of Havana from 1996 to 2005, were revised. Patients of 61 and 70 years, 25 (45.45 %) predominated, as well as the one of 51 and 60 years, 15 (27.27 %). The glottal larynx was the most frequent topographical location with 28 patients (50.9 %). Objective responses in the 94.54 % of the patients were obtained, the 4.5 % conserved its larynx, in most of these responses were obtained, the complete response was evident in 36 (65.45 %) and the partial one in 16 (29.09 %).

Exanguinotransfusión en el paciente politraumatizado grave y con sepsis / Exchange transfusion in the severe septic polywonded patient

Se realizó un estudio prospectivo longitudinal y descriptivo sobre la exanguinotransfusión en pacientes politraumatizados graves y con cuadro de sepsis ingresados en la Sala de Politrauma del Hospital Provincial Docente Manuel Ascunce Domenech de Camagüey, desde enero de 2003 a febrero de 2005. El universo estuvo constituido por 20 pacientes, el grupo de edad más afectado fue el de 30-44 años con nueve casos. De 45 exanguinotransfusión realizadas, 30 se efectuaron del cuarto al séptimo días con magníficos resultados, la complicación más frecuente fue la acidosis metabólica con nueve casos, seguida de la alcalosis metabólica con seis pacientes. Los mejores resultados estuvieron en relación con la precocidad del proceder y no con el mayor número. De los 20 enfermos, cuatro fallecieron, dos por sepsis, uno por edema cerebral severo y otro con un infarto del miocardio. La exanguinotransfusión demostró ser un proceder útil en los restantes 16 pacientes

Importancia anátomo-quirúrgica de la segmentación vascular renal / Anatomical and surgical importance of renal vascular segmentation

El objetivo del presente trabajo es la descripción de la segmentación vascular del riñón para prevenir las dificultades que se producen con las variaciones anatómicas en la cirugía conservadora del riñón...El conocimiento preciso de la segmentación vascular del riñón y la interpretación de la angiografía del órgano posibilita la realización de nefrectomías parciales