SEOM clinical guideline for secondary prevention (2019).

Cancer is one of the major public health problems in our society. It is estimated that more than 18 million new cases are diagnosed worldwide every year; 280,000 in Spain. Incidence in following a growing trend. This epidemic could be controlled with research into new treatments and, above all, with adequate prevention. Primary prevention could prevent avoid up to half of all cases. For many others, secondary prevention is essential, as it make diagnosis possible in the stages of the disease when it is easily curable. These guidelines present the scientific evidence regarding secondary prevention in tumors in which its use is well-accepted: breast, cervical, colorectal, prostate, lung, ovarian, melanoma, and gastric cancer.

Yttrium orthoaluminate nanoperovskite doped with Tm3+ ions as upconversion optical temperature sensor in the near-infrared region.

The thermal sensing capability of the Tm3+-doped yttrium orthoaluminate nanoperovskite in the infrared range, synthetized by a sol-gel method, was studied. The temperature dependence of the infrared upconverted emission bands located at around 705 nm (3F2,3→3H6) and 800 nm (3H4→3H6) of YAP: Tm3+ nanoperovskite under excitation at 1210 nm was analyzed from RT up to 425 K. Calibration of the optical sensor has been made using the fluorescence intensity ratio technique, showing a high sensitivity in the near-infrared compared to other trivalent rare-earth based optical sensors working in the same range. In addition, a second calibration procedure of the YAP: Tm3+ optical sensor was performed by using the FIR technique on the emission band associated to the 3H4→3H6 transition in the physiological temperature range (293-333 K), showing a very high relative sensitivity compared with other rare-earth based optical temperature sensors working in the physiological range. Moreover, the main advantage compared with other optical sensors is that the excitation source and the upconverted emissions do not overlap, since they lie in different biological windows, thus allowing its potential use as an optical temperature probe in the near-infrared range for biological applications.

Portable IR dye laser optofluidic microresonator as a temperature and chemical sensor.

A compact and portable optofluidic microresonator has been fabricated and characterized. It is based on a Fabry-Perot microcavity consisting essentially of two tailored dichroic Bragg mirrors prepared by reactive magnetron sputtering deposition. The microresonator has been filled with an ethanol solution of Nile-Blue dye. Infrared laser emission has been measured with a pump threshold as low as 0.12 MW/cm2 and an external energy conversion efficiency of 41%. The application of the device as a temperature and a chemical sensor is demonstrated. Small temperature variations as well as small amount of water concentrations in the liquid laser medium are detected as a shift of the resonant laser modes.

Slow magnetic relaxation mechanisms in erbium SIMs.

The magnetic properties of two similar Er(3+) complexes have been investigated. [Er(tpm)3(bipy)] (Htpm = 1,1,1-trifluoro-5,5-dimethyl-2,4-hexanedione and bipy = 2,2'-bipyridine) displays thermally activated slow relaxation of magnetisation under a zero direct-current (DC) field. Under an applied HDC field of 1000 G, [Er(tpm)3(bipy)] exhibits two thermally activated processes with energy barriers of 9 and 40 K, while [Er(tfa)3(bipy)] (Htfa = 4,4,4-trifluoro-1-(2-furyl)-1,3-butanedione) shows only one activated process with a barrier of 15 K. Both compounds are luminescent in the solid state, emitting in the near IR region.

Active layer solution-processed NIR-OLEDs based on ternary erbium(III) complexes with 1,1,1-trifluoro-2,4-pentanedione and different N,N-donors.

Using a fluorinated 1,1,1-trifluoro-2,4-pentanedione (Htfac) ligand and either 2,2'-bipyridine (bipy), bathophenanthroline (bath) or 5-nitro-1,10-phenanthroline (5NO2phen) as an ancillary ligand, three new ternary erbium(iii) octacoordinated complexes have been synthesized. The single crystal structures of the new complexes (namely [Er(tfac)3(bipy)], [Er(tfac)3(bath)] and [Er(tfac)3(5NO2phen)]) have been determined and their properties have been investigated by Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy and thermodynamic analysis. After ligand-mediated excitation of these complexes in the UV, they all show the characteristic near-infrared (NIR) luminescence of the corresponding Er(3+) ion at 1532 nm. The same emission in the C-band transmission window can also be obtained from the solution-processed organic light-emitting diodes (OLEDs) with structure: glass/ITO/PEDOT:PSS/[Er(tfac)3(N,N-donor)]/Ca/Al. In spite of the fact that the photoluminescence intensity of [Er(tfac)3(5NO2phen)] is stronger than those of [Er(tfac)3(bipy)] and [Er(tfac)3(bath)], the best electroluminescence results correspond to the OLED based on the [Er(tfac)3(bath)] complex, as a consequence of the superior electron transport capabilities of bathophenanthroline.

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.

High-sensitivity fluorescence lifetime thermal sensing based on CdTe quantum dots.

The potential use of CdTe quantum dots as luminescence nano-probes for lifetime fluorescence nano-thermometry is demonstrated. The maximum thermal sensitivity achievable is strongly dependent on the quantum dot size. For the smallest sizes (close to 1 nm) the lifetime thermal sensitivity overcomes those of conventional nano-probes used in fluorescence lifetime thermometry.

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.

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.

Role of the local structure and the energy trap centers in the quenching of luminescence of the Tb3+ ions in fluoroborate glasses: a high pressure study.

The concentration and pressure dependent luminescence properties of the Tb(3+) ions in a lithium fluoroborate glasses have been studied by analyzing the deexcitation processes of the (5)D(4) level at ambient conditions as well as a function of pressure up to 35 GPa at room temperature. The luminescence spectra of Tb(3+) ions have been measured as a function of pressure and observed a continuous redshift as well as a progressive increase in the magnitude of the crystal-field splittings for the (5)D(4)-->(7)F(3,4,5) transitions. Monitoring the (5)D(4)-->(7)F(5) transition, the luminescence decay curves have been measured and analyzed in order to understand the dynamics of the deexcitation of the Tb(3+) ions in these glasses. At ambient conditions a nonexponential behavior has been found for doping concentrations as low as 0.1 mol % of Tb(4)O(7), although no cross-relaxation channels exist to explain this behavior. The modelization of the energy transfer processes surprisingly shows that the nonexponential character of the decay curves of the (5)D(4) level with concentration or with pressure has to be ascribed to energy transfer to traps without migration of energy between Tb(3+) ions. For all the experimental situations the nonexponential character of the decay curves is well described by the generalized Yokota-Tanimoto model with a dipole-dipole interaction between the Tb(3+) ions and the nearby luminescence quenching traps. The luminescence properties observed with releasing pressure are slightly different to those obtained while increasing pressure suggesting a local structural hysteresis in the lithium fluoroborate glass matrix giving rise to the generation of a new distribution of environments for the Tb(3+) ions.

Nanocrystals distribution inside the writing lines in a glass matrix using Argon laser irradiation.

Localized modification in strontium barium niobate glass doped with Ho(3+) under laser irradiation has been carried out. The preliminary samples of this study have been fabricated by the melt quenching method and doped with 2.5% mol of Ho(3+). A 3.5W cw multiline Ar-laser has been focused and shifted in a line during laser irradiation. The formation of Strontium Barium Niobate nanocrystals has been confirmed by X-ray diffraction, atomic force microscope image and fluorescence. They have been localized in the irradiation line and change the optical properties of the sample. These nanocrystals have been obtained due to the excitation of the Ho(3+) ions which under nonradiative processes produced the heating of the sample. In this work, it has been demonstrated that the diffusion of the Nb(5+) ions to the border of the irradiated line controls the growth of the nanocrystals in the sample.

Growth of nanocrystals in a Nd3+-Yb3+ codoped oxyfluoride glass by laser irradiation.

A local nanocrystalline formation in a Neodymium-Ytterbium codoped oxyfluoride glass has been obtained. It has been studied the intense emissions around 880 and 975 nm originated from the 4F3/2(Nd3+) and 2F5/2(Yb3+) levels when the glass structure changes to a glass ceramic structure due to the irradiation of the laser beam. The emission spectra before and after the irradiation with 2900 mW reveals that the desvitrification process made by the laser power beam has been successfully achieved. The intensities and lifetime changes of these levels inside and outside the hole made by the laser damage have been analyzed. These results confirm that nanocrystals of betaPbF2 have been created by the laser action confirming that the transition from glass to glass ceramic has been completed. These results are in agreement with the bulk spectroscopic measurements.

Dopant distribution in a Tm(3+)-Yb(3+) codoped silica based glass ceramic: an infrared-laser induced upconversion study.

The optically active dopant distribution in a Tm(3+)-Yb(3+) doped silica based glass ceramic sample has been investigated. A systematic analysis of the upconversion fluorescence of the Tm(3+)-Yb(3+) codoped glass and glass ceramic has been performed at room temperature. Tm(3+) and Yb(3+) single doped glass and glass ceramics have also been included in the study. Upon infrared excitation at 790 nm into the (3)H(4) level of the Tm(3+) ions a blue upconversion emission is observed, which is drastically increased in the Yb(3+) codoped samples. A rate equation model confirmed the energy transfer upconversion mechanism. Based on these results, the temporal dynamic curves of the levels involved in the upconversion process, (3)H(4), (2)F(5/2), and (1)G(4) were interpreted in the glass ceramic samples. The contribution of the optically active Tm(3+) and Yb(3+) ions in the crystalline and in the vitreous phase of the glass ceramic was distinguished and the ratio of Tm(3+) ions in the crystalline phase could be quantified for the 1 mol % Tm(3+)-2.5 mol % Yb(3+) glass ceramic. A surprising result was obtained for that concentration: the main contribution to the upconversion emission of the glass ceramic is due to Tm(3+)-Yb(3+) ions in the vitreous phase.

Care plans for acutely deteriorating COPD: a randomized controlled trial.

INTRODUCTION: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a frequent reason for admission to hospital and are responsible for the majority of the direct economic costs of treating COPD. AIMS: To test whether an individualized care plan for patients experiencing acute exacerbations of COPD result in reduced health care utilization and improved quality of life for patients. METHODS: Ninety-two patients with confirmed COPD were selected by general practitioners or district nurses, and randomly assigned to care plan or usual care groups. The care plan was developed in collaboration with general practitioners, secondary care specialists, specialist nurses, ambulance service providers and the after hours clinic. Patients were followed for 12 months, and the primary end-points were frequency of use of primary care services and hospital admissions. RESULTS: There was no significant reduction in hospital admissions or improvement in quality of life in the group of patients who used the care plan compared to controls. The care plan group called out the ambulance service more frequently [2.8 (1.3, 4.3) versus 1.1 (0.7, 1.5) calls per 12 months; P = 0.03], and there was a trend towards greater use of oral prednisone [2.3 (1.4, 3.2) versus 1.3 (0.8, 1.8) courses per 12 months; P = 0.06]. CONCLUSION: In contrast to asthma, the provision of individualized self-management plans, whose content was enhanced to provide guidance to carers and health care professionals, did not reduce health care utilization or improve overall quality of life during acute exacerbations of COPD. Other strategies are required.

Nosocomial pneumonia in adult general medical and surgical patients at Christchurch Hospital.

AIMS: To determine the incidence, microbial cause, and outcome of nosocomial pneumonia in adult general medical and surgical patients at Christchurch Hospital. METHOD: A one-year prospective study of consecutive patients developing nosocomial pneumonia in a university-affiliated hospital. Expanded diagnostic laboratory testing was undertaken to identify the microbial cause of pneumonia. RESULTS: We recruited 126 patients, which represented an incidence of 6.1 per 1,000 admissions. Only 52 (41%) patients submitted sputum that satisfied the cytological screening criteria for testing. A microbial cause was identified in 47 cases (37%): the most common was Legionella spp. (sixteen cases), followed by Influenza A (six cases) and Staphylococcus aureus (four cases). We did not identify an environmental source of the Legionella species. Fourteen patients (11%) died as a consequence of pneumonia and nearly all of these had significant comorbidity. Renal impairment, alcohol excess, and severity of pneumonia were the most powerful predictors of a fatal outcome by univariate analysis. CONCLUSIONS: In most patients we did not identify a microbial cause of pneumonia; when we did, Legionella species were the most common, although this micro-organism has a long incubation period so some subjects may have acquired it before admission. These results guide preventative efforts, diagnostic testing and selection of antimicrobial therapy for nosocomial pneumonia in our hospital.

Cat allergen levels in public places in New Zealand.

AIMS: Cat allergen (Fel d 1) is a known risk factor for asthma. Studies have demonstrated Fel d 1 in both public buildings and domestic dwellings where cats have never been. The aims of this study were to measure reservoir Fel d 1 levels in public buildings in New Zealand, to examine determinants of these levels and to compare them with previously measured domestic levels. METHODS: Dust was obtained in two centres (Wellington and Christchurch) from hotels, hospitals, rest homes, churches, primary schools, childcare centres, cinemas, bank head offices and aeroplanes; and from North Island ski lodges. Measurements of temperature and relative humidity were taken. Information was collected on building characteristics. Fel d 1 levels (microg/g of fine dust) for floors (n=203), beds (n=64) and seats (n=24) were expressed as geometric means (95% confidence intervals). RESULTS: Detectable Fel d 1 levels were found in 95% of floor samples, 91% of bed samples and 100% of seat samples. Fel d 1 levels [geometric mean (95% confidence intervals)] were significantly higher on cinema and domestic aircraft seats [36.8 (20.8-65.3) microg/g and 33.3 (28.0-39.7) microg/g respectively] than on floors [3.6 (2.5-5.1) microg/g and 2.4 (1.8-3.0) microg/g respectively]. Floor Fel d 1 levels in the public buildings sampled were lower than those of domestic dwellings without cats [0.9 (0.6-1.4) microg/g vs 1.7 (1.2-2.4)] microg/g in Wellington and [2.0 (1.6-2.6) microg/g vs 4.0 (2.7-6.0] microg/g in Christchurch. After controlling for potential confounders, floor Fel d 1 levels were higher with carpeted floors (p<0.001) and lower in banks and hospitals (p<0.001). CONCLUSION: Fel d 1 levels in public buildings are low in New Zealand public places except for cinema and domestic aircraft seats where all but one sample had Fel d 1 levels potentially high enough to precipitate asthma symptoms in sensitised individuals.

House dust mite and cat allergen levels in domestic dwellings in Christchurch.

AIMS: To quantify the levels of Dermatophagoides pteronyssinus allergen (Der p I) and Felis domesticus allergen (Fel d I) in domestic dwellings in Christchurch and to assess possible relationships with housing characteristics. METHODS: Domestic dwellings (n = 93) were randomly selected and housing characteristics documented during the summer of 1994/95. Dust samples were obtained from the floor of the living room (LR) and bedroom (BR) and from the bed by standard vacuuming methods. The predominant mite species were determined and D pteronyssinus and F domesticus levels quantified. RESULTS: D pteronyssinus was the predominant (95%) species. D pteronyssinus allergen levels [geomean (95% confidence intervals) were 3.5(2.5-4.8) micrograms/g in LR, 10.1(7.5-13.7) micrograms/g in BR and 5.7(4.3-7.6) micrograms/g in the bed. F domesticus allergen levels were significantly higher (p < 0.001) in houses with cats than without cats [median (range) 93.2 (3.3-1227.2) micrograms/g and 2.9 (0.4-214.8) micrograms/g respectively]. Higher LR D pteronyssinus allergen levels were found in houses classified as having high indoor humidity and in houses situated in geographically damp locations. CONCLUSIONS: Domestic D pteronyssinus and F domesticus allergen levels in Christchurch are comparable with those found in other climatically similar locations. D pteronyssinus allergen levels are associated with both indoor and outdoor humidity factors.

Climate and aeroallergen levels in asthma: a 12 month prospective study.

BACKGROUND: There is evidence to suggest that changes in weather and airborne fungal spore and pollen counts may affect asthma symptoms. METHODS: The relationship between climate, airborne fungal spore, and pollen counts and peak expiratory flow rate (PEFR) and asthma symptoms was prospectively investigated in a population of mild to moderate asthmatic subjects in Blenheim, New Zealand. Subjects recorded twice daily PEFR measurements and asthma symptom scores for up to one year. Spore and pollen counts were measured two hourly and meteorological data were measured hourly. Individual, within person, multiple linear regression analyses were conducted, adjusting for auto-correlation. A random effects model was assumed for the individual regression co-efficients and weighted estimates of the mean of these coefficients were obtained by the method of maximum likelihood. RESULTS: One hundred and thirty nine asthmatic patients (60% atopic) aged 17-80 years completed the study. Of the weather variables, only temperature showed a small but consistent association with PEFR. The mean rise in PEFR for an 8.8 degrees C (2 SD) change in temperature was 0.78% (95% CI 0.44% to 1.11%), approximately 3.0 l/min. There was a weak association between days of high basidiospore counts and increased nocturnal wakening and reliever medication use. Pollen counts showed no consistent association with either PEFR or asthma symptoms. CONCLUSIONS: The results of this study suggest that the effects of weather and aeroallergens on PEFR and asthma symptoms in this population are small, and that other causes need to be sought to account for variations in asthma severity and exacerbations.

Tumour presenting as a retrosternal abscess following median sternotomy.

A 73-year-old lady, who underwent coronary artery bypass grafting eight months previously, presented with rigors and chest pain. The upper sternum was tender, swollen and erythematous, suggesting a retrosternal abscess. Radiological investigation supported the clinical diagnosis. Local infections following median sternotomy are uncommon, most being early and superficial. Late infections are very uncommon, and should suggest alternative pathology. Following open surgical drainage, histology showed the mass to be a poorly differentiated adenocarcinoma. The primary tumour was never found.

Respiratory effects of air pollution in chronic obstructive pulmonary disease: a three month prospective study.

BACKGROUND: A study was undertaken to investigate the relationship between air pollution levels and respiratory symptoms and peak expiratory flow rate (PEFR) in subjects with chronic obstructive pulmonary disease (COPD) living in Christchurch, New Zealand. METHODS: Forty subjects aged over 55 years with COPD completed twice daily diaries for three months during the winter of 1994. Subjects recorded respiratory symptoms, PEFR, outdoor activity, visits to doctor or hospital, and medication use. All were resident within a 5 km radius of the regional council's air pollution monitoring site. Daily and hourly mean pollutant levels (particulates (PM10, nitrogen dioxide (NO2), sulphur dioxide (SO2) and carbon monoxide (CO)) were measured at the monitoring site. RESULTS: Pollution levels were generally low relative to those recorded in previous years. The New Zealand Ministry for the Environment guidelines for PM10 were exceeded on five occasions, and for CO six times. No association was found between PEFR and any of the pollution variables. A rise in the PM10 concentration equivalent to the interquartile range was associated with an increase in night time chest symptoms (relative risk 1.38, 95% CI 1.07 to 1.78). A rise in NO2 concentrations equivalent to the interquartile range was associated with increased reliever inhaler use (relative risk 1.42, 95% CI 1.13 to 1.79) and for 24 hour lag analysis with increased nebuliser use (relative risk 2.81, 95% CI 1.81 to 4.39). There was no increase in the relative risk of other symptoms in relation to pollution levels. CONCLUSIONS: These effects, demonstrated in a small susceptible group of subjects with COPD, indicate that adverse outcomes can be measured in response to pollution levels that are within current guidelines.