Intermediate-Range Casimir-Polder Interaction Probed by High-Order Slow Atom Diffraction.

At nanometer separation, the dominant interaction between an atom and a material surface is the fluctuation-induced Casimir-Polder potential. We demonstrate that slow atoms crossing a silicon nitride transmission nanograting are a remarkably sensitive probe for that potential. A 15% difference between nonretarded (van der Waals) and retarded Casimir-Polder potentials is discernible at distances smaller than 51 nm. We discuss the relative influence of various theoretical and experimental parameters on the potential in detail. Our work paves the way to high-precision measurement of the Casimir-Polder potential as a prerequisite for understanding fundamental physics and its relevance to applications in quantum-enhanced sensing.

Viscoinertial regime of immersed granular flows.

By means of extensive coupled molecular dynamics-lattice Boltzmann simulations, accounting for grain dynamics and subparticle resolution of the fluid phase, we analyze steady inertial granular flows sheared by a viscous fluid. We show that, for a broad range of system parameters (shear rate, confining stress, fluid viscosity, and relative fluid-grain density), the frictional strength and packing fraction can be described by a modified inertial number incorporating the fluid effect. In a dual viscous description, the effective viscosity diverges as the inverse square of the difference between the packing fraction and its jamming value, as observed in experiments. We also find that the fabric and force anisotropies extracted from the contact network are well described by the modified inertial number, thus providing clear evidence for the role of these key structural parameters in dense suspensions.

Causas de estridor. Laringomalacia: dos formas de presentación poco habituales / Stridor causes. Laryngomalacia: two infrequent cases

La laringomalacia es la principal causa de estridor en la infancia, que se resuelve espontáneamente la mayoría de los casos antes de los dos años de vida. Sin embargo, un pequeño porcentaje no presenta esta evolución favorable, por lo que es importante identificar los casos graves con repercusión clínica y conocer el abanico de patologías con las que es necesario plantear un diagnóstico diferencial. Los principales signos de alarma son la presencia de apneas y el fallo de medro. Presentamos dos casos de interés en este sentido, el primero por la gravedad y precocidad de la repercusión clínica, el segundo por el retraso en la resolución espontánea, con síntomas vividos con gran ansiedad por los familiares. Una buena anamnesis, incluyendo antecedentes perinatales y quirúrgicos, y una exploración física completa (características del estridor, rasgos dismórficos, lesiones cutáneas…) son clave para el enfoque diagnóstico adecuado. La nasofaringolaringoscopia flexible en vigilia permite el diagnóstico de gran parte de anomalías supraglóticas, si bien puede no detectar disfunciones dinámicas que se ocasionan solo en ciertas situaciones (por ejemplo, con el paciente dormido en decúbito supino). La fibrobroncoscopia bajo sedación, en respiración espontánea, se ha demostrado una prueba segura y eficaz en el diagnóstico de certeza de las diferentes causas de estridor, presentando además la ventaja de poder ser utilizada como vía de acceso para diferentes procedimientos terapéuticos en el mismo acto médico, aumentando el grado de sedación/anestesia según se requiera (AU)

Laryngomalacia is the most common congenital laryngeal abnormality underlying stridor in infants, and usually resolves spontaneously before two years of age. However, a small percentage of cases have no such favorable evolution, so it is important to identify severe cases with clinical consequences and perform a thorough differential diagnosis. Principal signs of concern are the presence of apnea or failure to thrive. We present two cases of interest in this field, one because of severe clinical consequences at early onset and the other because of late resolution with sleeping apnea episodes lived as threatening by the family. A careful clinical anamnesis, including perinatal details and surgical history, and a complete physical examination (stridor characteristics, peculiar facial features, skin lesions) are the key to an appropriate diagnosis approach. Awake flexible nasopharyngolaryngoscopy may achieve diagnosis of most supraglotic abnormalities, even though it may fail when detecting dynamic dysfunctions appearing only in certain circumstances (e.g. asleep patient in supine position). Fibrobronchoscopy under sedation, in patients breathing spontaneously, has been proven a safe and effective tool in the differential diagnosis of stridor in childhood. Moreover, it can be used as therapeutic approach in the same procedure, by means of different techniques under deep sedation or general anesthesia depending on their complexity (AU)

Estimación semiautomática de la densidad mamaria con DM-Scan / Semiautomatic estimation of breast density with DM-Scan software

Objetivo. Evaluar la reproducibilidad del cálculo de la densidad mamaria con la aplicación informática DM-Scan, basada en la segmentación semiautomática del tejido fibroglandular, y compararla con la de la inspección visual. Material y métodos. El estudio incluyó 655 mamografías digitales directas en proyección cráneo-caudal. Tres expertos radiólogos analizaron la densidad de las mamografías con DM-Scan, y se calcularon las concordancias inter e intraobservador entre pares de radiólogos para las escalas Boyd y BI-RADS®, utilizando el índice de correlación intraclase. Las concordancias se compararon con las obtenidas previamente para la inspección visual, en el mismo conjunto de imágenes, utilizando el índice Kappa. Resultados. Con el análisis visual, la concordancia media interobservador fue de 0,876 (IC 95%: 0,873-0,879) para la escala de Boyd, y 0,823 (IC 95%: 0,818-0,829) para la clasificación BI-RADS®. La concordancia intraobservador fue de 0,813 (IC 95%: 0,796-0,829) para la escala de Boyd, y 0,770 (IC 95%: 0,742-0,797) para la clasificación BI-RADS®. Con DM-Scan, la concordancia media inter e intraobservador fue de 0,92, notablemente superior a las concordancias de la clasificación visual. Conclusión. El cálculo de la densidad mamaria con la aplicación semiautomática DM-Scan es más fiable y reproducible, y disminuye la subjetividad y variabilidad de la estimación visual (AU)

Objective. To evaluate the reproducibility of the calculation of breast density with DM-Scan software, which is based on the semiautomatic segmentation of fibroglandular tissue, and to compare it with the reproducibility of estimation by visual inspection. Material and methods. The study included 655 direct digital mammograms acquired using craniocaudal projections. Three experienced radiologists analyzed the density of the mammograms using DM-Scan, and the inter- and intra-observer agreement between pairs of radiologists for the Boyd and BI-RADS® scales were calculated using the intraclass correlation coefficient. The Kappa index was used to compare the inter- and intra-observer agreements with those obtained previously for visual inspection in the same set of images. Results. For visual inspection, the mean interobserver agreement was 0,876 (95% CI: 0,873-0,879) on the Boyd scale and 0,823 (95% CI: 0,818-0,829) on the BI-RADS® scale. The mean intraobserver agreement was 0,813 (95% CI: 0,796-0,829) on the Boyd scale and 0,770 (95% CI: 0,742-0,797) on the BI-RADS® scale. For DM-Scan, the mean inter- and intra-observer agreement was 0,92, considerably higher than the agreement for visual inspection. Conclusion. The semiautomatic calculation of breast density using DM-Scan software is more reliable and reproducible than visual estimation and reduces the subjectivity and variability in determining breast density (AU)

Semiautomatic estimation of breast density with DM-Scan software.

OBJECTIVE: To evaluate the reproducibility of the calculation of breast density with DM-Scan software, which is based on the semiautomatic segmentation of fibroglandular tissue, and to compare it with the reproducibility of estimation by visual inspection. MATERIAL AND METHODS: The study included 655 direct digital mammograms acquired using craniocaudal projections. Three experienced radiologists analyzed the density of the mammograms using DM-Scan, and the inter- and intra-observer agreement between pairs of radiologists for the Boyd and BI-RADS® scales were calculated using the intraclass correlation coefficient. The Kappa index was used to compare the inter- and intra-observer agreements with those obtained previously for visual inspection in the same set of images. RESULTS: For visual inspection, the mean interobserver agreement was 0,876 (95% CI: 0,873-0,879) on the Boyd scale and 0,823 (95% CI: 0,818-0,829) on the BI-RADS® scale. The mean intraobserver agreement was 0,813 (95% CI: 0,796-0,829) on the Boyd scale and 0,770 (95% CI: 0,742-0,797) on the BI-RADS® scale. For DM-Scan, the mean inter- and intra-observer agreement was 0,92, considerably higher than the agreement for visual inspection. CONCLUSION: The semiautomatic calculation of breast density using DM-Scan software is more reliable and reproducible than visual estimation and reduces the subjectivity and variability in determining breast density.

Casos clínicos en Endocrinología nº 1: niña de seis años con pubarquia / Clinical Cases in Endocrinology nº 1: six year old girl with pubarche

Comenzamos con este artículo la publicación de una serie de casos en Endocrinología pediátrica que constituyen un motivo de consulta frecuente en Atención Primaria y que, aunque la mayoría de las veces tienen que ser derivados a Atención Especializada, es interesante conocer tanto el diagnóstico final como el tratamiento. En este primer caso, se trata de una niña de seis años con pubarquia. Se discute el diagnóstico diferencial y el tratamiento (AU)

We start with this article the publication of a series of cases in pediatric endocrinology that are a frequent consultation in primary care. Although most of them have to be referred to specialist care, it is interesting to know the final diagnosis and the treatment. This first case is a 6 year old girl with pubarche. Differential diagnosis and treatment are discussed (AU)

Collapse dynamics and runout of dense granular materials in a fluid.

We investigate the effect of an ambient fluid on the dynamics of collapse and spread of a granular column simulated by means of the contact dynamics method interfaced with computational fluid dynamics. The runout distance is found to increase as a power law with the aspect ratio of the column, and, surprisingly, for a given aspect ratio and packing fraction, it may be similar in the grain-inertial and fluid-inertial regimes but with considerably longer duration in the latter case. We show that the effect of fluid in viscous and fluid-inertial regimes is to both reduce the kinetic energy during collapse and enhance the flow by lubrication during spread. Hence, the runout distance in a fluid may be below or equal to that in the absence of fluid due to compensation between those effects.

Scattering of slow metastable argon atoms by dielectric nanospheres.

The elastic scattering at low energy of metastable argon atoms with internal angular momentum J = 0 and 2 by dielectric nanospheres is investigated. The differential cross sections are calculated for both isotropic and anisotropic interactions. A polarization effect is clearly evidenced. The possible use of a metastable atom beam as a probe of an ensemble of nanospheres deposited on a passive substrate is examined.

Negative-index media for matter-wave optics.

We consider the extension of optical metamaterials to matter waves and then the down scaling of metaoptics to nanometric wavelengths. We show that the generic property of pulsed comoving magnetic fields allows us to fashion the wave-number dependence of the atomic phase shift. It can be used to produce a transient negative group velocity of an atomic wave packet, which results into a negative refraction of the matter wave. Application to slow metastable argon atoms Ar(3P2) shows that the device is able to operate either as an efficient beam splitter or an atomic metalens.

Expectativas ante la reconstrucción mamaria en mujeres mastectomizadas / No disponible

Objetivo: El objetivo de este estudio es valorar las expectativasque las pacientes mastectomizadas tienen sobre elprocedimiento de la reconstrucción mamaria, entendiendopor expectativa la idea o creencia que la paciente tiene sobrelos cambios que la reconstrucción puede facilitar en diversasáreas de la persona. Se trata asimismo de relacionardichas expectativas con las respuestas emocionales y conlos cambios en la imagen corporal.Pacientes y métodos: La muestra consta de 61 mujeresmastectomizadas con una media de edad de 47,1 ± 6,6(rango entre 26 y 66 años), con evolución favorable de laenfermedad y que no reciben tratamientos complementarios.Acudieron a consulta de Cirugía Plástica del HospitalUniversitario La Fe de Valencia para iniciar el proceso dereconstrucción mamaria y fueron entrevistadas habiendotranscurrido un tiempo medio de 3,3 años (DT = 2,2), (rangoentre 9 meses y 10 años) desde la mastectomía. Para laevaluación de las expectativas se creó un cuestionario con31 ítems y 5 áreas: funcional-práctica, personal, sexual, derelación con los demás y una área técnica; además valoramosla satisfacción global esperada. Otros instrumentos utilizados:Escala Hospitalaria de Ansiedad y Depresión(HADS) de Zigmond y Snaith y cuestionario específico sobrecambios en relación con su cuerpo de López Pérez. Serealizaron análisis estadísticos descriptivos, correlación dePearson y ANOVA.Resultados: En conjunto las mujeres presentan mayoresexpectativas en la satisfacción global, el área funcionalprácticay los aspectos técnicos de la reconstrucción. Laspuntuaciones en la subescala de depresión y ansiedad correlacionaronpositivamente con las expectativas del área personal(autoestima y estado de ánimo), la sexualidad y la relacióncon los demás. También se aprecia una relaciónsignificativa entre una menor aceptación del cambio de imageny mayor presencia de síntomas depresivos y de ansiedad...(AU)

Objective: The aim of this study was to assess expectationson breast reconstruction procedure in mastectomisedpatients. The expectation construct means the idea or beliefthe woman has regarding changes that reconstruction canprovide in different personal areas. We also assess the relationbetween these expectations, anxiety and depressionand body image change.Patients and methods: The sample consisted of 61 mastectomisedwomen with a mean age of 47.1 ± 6.6 (age rangebetween 24 and 66 years), favourable disease progressand no additional treatments. Patients referred to PlasticSurgery consultation at the University Hospital La Fe in Valenciato initiate breast reconstruction procedure. The intervalbetween mastectomy and interview varied from 9 monthsto 10 years (mean of 3.3 years and SD = 2.2). A specificquestionnaire was performed to evaluate expectations. Itconsisted of 31 items and 5 areas: functional-practical, personal,sexual and social functioning and technical area.Furthermore, we assessed the expected global satisfaction.Other used instruments were: the Hospital Anxiety and DepressionScale (HADS) from Zigmond and Snaith, and aspecific questionnaire on body image change from LópezPérez. Descriptive, Pearson correlation and ANOVA statisticalanalyses were done.Results: Overall, women showed greater expectations onglobal satisfaction, functional-practical area and technicalaspects of breast reconstruction. Anxiety and depressionsub-scale scores were positively correlated with expectations on the personal area (self-esteem and emotional well-being),sexuality and social functioning. The results also showed astatistical significant correlation between a lower acceptanceof body image changes and a higher level of anxiety anddepression. On the other hand we found a negative correlationbetween body image changes and general satisfactionwith breast reconstruction procedure...(AU)

Ictericia prolongada por hipotiroidismo congénito transitorio y cribado neonatal negativo / No disponible

El hipotiroidismo congénito requiere un diagnóstico y un tratamiento precoces. A pesar de los programas de cribado neonatal, hay casos que se detectan tardíamente. Presentamos el caso de un lactante con hipotiroidismo congénito transitorio, con cribado neonatal negativo,detectado al segundo mes de vida por ictericia prolongada. El objetivo de este artículo es recordar que ante la presencia de síntomas como ictericia prolongada, es necesario descartar un hipotiroidismo aunque el resultado del cribado neonatal haya sido negativo

Congenital hypothyroidism is a clinical entity that requires prompt diagnosis and treatment. In spite of neonatal screening for congenital hypothyroidism, there are still cases that are diagnosed after the neonatal period. The case presented below is an infant with transient congenital hypothyroidism detected in the second month of life by prolonged jaundice. The objective of this article is to remember that in the presence of symptoms like prolonged jaundice, it is necessary to discard a congenital hypothyroidism even though the screening test at birth was normal

Bose-Einstein condensation of metastable helium.

We have observed a Bose-Einstein condensate in a dilute gas of 4He in the (3)2S(1) metastable state. We find a critical temperature of (4.7+/-0.5) microK and a typical number of atoms at the threshold of 8 x 10(6). The maximum number of atoms in our condensate is about 5 x 10(5). An approximate value for the scattering length a = (16+/-8) nm is measured. The mean elastic collision rate at threshold is then estimated to be about 2 x 10(4) s(-1), indicating that we are deeply in the hydrodynamic regime. The typical decay time of the condensate is 2 s, which places an upper bound on the rate constants for two-body and three-body inelastic collisions.

Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography.

PURPOSE: To evaluate short-term follow-up of nonpalpable probably benign lesions in a 2-year mammographic screening. MATERIALS AND METHODS: Of 13,790 women aged 45-65 years who underwent first-round screening, 795 (5.8%) underwent short-term mammographic follow-up (every 6 months for 2 years) of nonpalpable probably benign lesions (eg, masses, focal asymmetric densities, and calcifications) previously assessed at an additional imaging evaluation, including ultrasonography. When no changes were found at short-term mammographic follow-up, women were assigned to the 2-year screening interval. Needle localization and surgical biopsy were performed when the lesion progressed (was enlarged or had an increased number or size of calcifications or modification of their initial characteristics). The effectiveness of this approach was evaluated with statistical analysis. RESULTS: Of 795 lesions, 788 (99%) remained stable, and seven (1%) had changes prompting surgical biopsy. Two cancers (0.3%), one microinvasive intraductal carcinoma and one 7-mm invasive ductal carcinoma without positive nodes, were found. Four of the five benign histologic results were probably benign calcifications with progression at short-term follow-up. The sensitivity, specificity, accuracy, and positive and negative predictive values were 100%, 99%, 99%, 29%, and 100%, respectively. CONCLUSION: The benign nature of most nonpalpable probably benign lesions can be typified with short-term mammographic follow-up. This approach permitted identification of a few low-stage carcinomas, but progression in the probably benign calcifications was usually unrelated to malignancy.

Punción aspiración con aguja fina en lesiones mamarias probablemente benignas o malignas por radiografía / Fine-needle aspiration in breast lesions radiologically classified as probably bening or probably malignant

Objetivo: El propósito de nuestro trabajo es evaluar la validez de la punción aspiración con aguja fina (PAAF) en nuestro medio en dos grupos definidos por la clasificación radiográfica como lesiones probablemente benignas (PB) o probablemente malignas (PM). Material y Métodos: Se estudian retrospectivamente 96 lesiones mamarias, 55 clasificadas como PB y 41 como PM. En todas se realizó PAAF y se obtuvo comprobación histológica. Resultados: En las citologías de los 55 pacientes con lesión mamaria PB, encontramos en seis casos material insuficiente, 37 benignas, nueve sospechosas de malignidad y tres positivas. Se realizó estudio comparativo entre el informe citológico y el histológico. Hubo tres falsos negativos (FN) y dos falsos positivos (FP). Se obtuvo una especificidad del 99 por ciento y un valor predictivo negativo (VPN) del 92 por ciento. En las citologías de los 41 pacientes con lesión mamamria PM, encontramos cinco casos de material insuficiente, 21 positivas, nueve sospechosas de malignidad y seis negativas. Se realizó estudio comparativo entre el informe citológico y el histológico. Hubo dos FP y dos FN. Se obtuvo una sensibilidad y un valor predictivo positivo (VPP) del 93 por ciento. Conclusiones: Ante una lesión clasificada por radiografía como PB, la PAAF puede considerarse una buena alternativa frente a los controles radiológicos periódicos. Las lesiones clasificadas por radiografía como PM precisan biopsia para evitar los FN que existen con la PAAF (AU)

Breast cancer screening: first round in the population-based program in Valencia, Spain. Collaborative Group of Readers of the Breast Cancer Screening Program of the Valencia Community.

PURPOSE: To analyze the results of round 1 of the population-based Valencia Breast Cancer Screening Program. MATERIALS AND METHODS: In this program, 78,224 (72.98%) of the 107,178 women invited (aged 45-65 years) underwent screening. Complementary views were obtained in 5,771 women (7.38%). Among the total population studied, 3,502 (4.48%) underwent short-term mammographic follow-up studies; 3,898 (4.98%) underwent additional studies and treatment at hospitals. Five hundred eighty-seven women (0.75%) underwent biopsy. RESULTS: Cancer was detected in 334 patients (4.27 cancers per 1,000 women [3.24 per 1,000 women aged 45-49 years, 6.30 per 1,000 women aged 60-65 years]; six patients with lobular carcinoma in situ excluded). The estimated sensitivity was 89%; specificity, 99%. The positive predictive value of mammography was 8.56%; of mammography with additional examinations, 26.82%; and of biopsy, 56.89%. Forty-one patients (12.28%) had ductal carcinoma in situ; 284 (85.03%) had infiltrating carcinoma. In 73 (25.70%) of the 284 patients, infiltrating carcinomas were smaller than 1 cm. Two hundred twenty-five patients (76.27%) had no lymph node involvement. One hundred seventy-nine (61.09%) had stage 0 or 1 cancer. CONCLUSION: Results are consistent with other published results; differences are due to methods and patient population characteristics.

[Analysis of interval cancers in the Program of Early Diagnosis of Cancer of the Breast of the Community of Valencia. Group of Readers of the Prevention Units of Cancer of the Breast]. / Análisis de los cánceres de intervalo en el Programa de Diagnóstico Precoz de Cáncer de Mama de la Comunidad Valenciana. Grupo de Lectores de las Unidades de Prevención de Cáncer de Mama.

A retrospective search was performed of interval cancers in the Programa de Prevención de Cáncer de Mama de la Comunidad Valenciana. The cancer rate observed was 0.5 per 1,000 women studied. The mean diagnostic time from the first mammography was 11 months, and the most frequent detection means was a positive palpation. The frequency was higher in women aged less than 55 years. More "non-common" histologic types were found and a lower percentage of conservative therapies regarding cancers detected at the first round of the Program, although the stage was similar to the latter.