Sarcoma de Ewing extraesquelético en cavidad nasal y senos paranasales, reporte de caso / Extra-skeletal Ewing sarcoma in the nasal cavity and paranasal sinus, case report

El sarcoma de ewing es un tumor maligno de rápido crecimiento, con prevalencia de 1-5 casos por cada 1.000.000 habitantes, su forma extraesquelética en la cavidad sinonasal o senos paranasales es inusual. Objetivo: describir la localización atípica de esta neoplasia y la importancia de lograr un diagnóstico oportuno. Paciente femenina, con una masa en la cavidad nasal derecha de dos meses de evolución, cefalea y epistaxis. Con asimetría en región orbitaria derecha y deformidad del tabique nasal, senos paranasales con sintomas de obstrucción. La tomografía reveló una masa que invade senos paranasales. La biopsia mostró un sarcoma de Ewing. Se confirmó con CD99. La paciente recibió quimioterapia y plan de resección quirúrgica, pero falleció. El diagnóstico y tratamiento oportuno del sarcoma de ewing en cavidad sinonasal debe apoyarse con examenes tomográficos, histopatológicos, inmunohistoquímicos y de ser posible citogenéticos para llegar al diagnóstico definitivo en etapas tempranas del tumor

Ewing's sarcoma is a rapidly growing malignant tumor, with a prevalence of 1-5 cases per 1,000,000 inhabitants, its extraskeletal shape in the sinonasal cavity or paranasal sinuses is unusual. Objective: to describe the atypical location of this neoplasm and the importance of achieving a timely diagnosis. Female patient, with a mass in the right nasal cavity of two months of evolution, headache and epistaxis. With asymmetry in the right orbital region and deformity of the nasal septum, paranasal sinuses with symptoms of obstruction. Tomography revealed a mass that invades the paranasal sinuses. The biopsy showed Ewing's sarcoma. It was confirmed with CD99. The patient received chemotherapy and a surgical resection plan, however she died. The timely diagnosis and treatment of Ewing's sarcoma in the sinonasal cavity should not be based solely on clinical evaluation, it requires a tomographic, histopathological, immunohistochemical and, if possible, cytogenetic examination to reach a definitive diagnosis in the early stages of the tumor.

Recycling of Waste Toner Powder as Adsorbent to Remove Aqueous Heavy Metals.

The removal of Cd2+, Zn2+ and Ni2+ from metal solutions onto waste toner power (WTP) was investigated. The influence of parameters such as pH, contact time, initial metal concentration and adsorbent dosage was studied in batch adsorption experiments. Batch equilibrium experiments showed that the highest removal efficiency for Zn2+ and Cd2+ occurs at pH 7, while pH 5 is the most suitable for Ni2+ removal. The amount of metal removed (mg/g) improved when increasing the initial concentration, and sorption of heavy metals reached equilibrium in 24 h. Metals' uptake increased with increasing adsorbent dosage. The adsorption isotherms of Zn2+, Cd2+ and Ni2+ onto WTP fit the Langmuir better than the Freundlich model with correlation coefficient R2 values ranging from 0.998 to 0.968 and 0.989 to 0.881, respectively. The data showed that the maximum adsorption capacity of heavy metals, amax, ranged from 2.42 to 1.61 mg/g, from 6.22 to 2.01 mg/g and from 3.49 to 2.56 mg/g for Ni2+, Zn2+ and Cd2+, respectively, with the three WTPs used in this study. This adsorbent can potentially be used to remove metal ions from wastewater.

Stimulated Generation of Indistinguishable Single Photons from a Quantum Ladder System.

We propose a scheme for the generation of highly indistinguishable single photons using semiconductor quantum dots and demonstrate its performance and potential. The scheme is based on the resonant two-photon excitation of the biexciton followed by stimulation of the biexciton to selectively prepare an exciton. Quantum-optical simulations and experiments are in good agreement and show that the scheme provides significant advantages over previously demonstrated excitation methods. The two-photon excitation of the biexciton suppresses re-excitation and enables ultralow multiphoton errors, while the precisely timed stimulation pulse results in very low timing jitter of the photons, and consequently, high indistinguishability. In addition, the polarization of the stimulation pulse allows us to deterministically program the polarization of the emitted photon (H or V). This ensures that all emission of interest occurs in the polarization of the detection channel, resulting in higher brightness than cross-polarized resonant excitation.

Origin of Antibunching in Resonance Fluorescence.

Resonance fluorescence has played a major role in quantum optics with predictions and later experimental confirmation of nonclassical features of its emitted light such as antibunching or squeezing. In the Rayleigh regime where most of the light originates from the scattering of photons with subnatural linewidth, antibunching would appear to coexist with sharp spectral lines. Here, we demonstrate that this simultaneous observation of subnatural linewidth and antibunching is not possible with simple resonant excitation. Using an epitaxial quantum dot for the two-level system, we independently confirm the single-photon character and subnatural linewidth by demonstrating antibunching in a Hanbury Brown and Twiss type setup and using high-resolution spectroscopy, respectively. However, when filtering the coherently scattered photons with filter bandwidths on the order of the homogeneous linewidth of the excited state of the two-level system, the antibunching dip vanishes in the correlation measurement. Our observation is explained by antibunching originating from photon-interferences between the coherent scattering and a weak incoherent signal in a skewed squeezed state. This prefigures schemes to achieve simultaneous subnatural linewidth and antibunched emission.

Acceptability of Sexual Violence Against Women In Spain: Demographic, Behavioral, and Attitudinal Correlates.

Most research on the social perception of sexual violence is based on samples of university students, while it is rare to find studies with representative samples, despite the vital importance of this information in planning prevention strategies. Furthermore, in Europe, the social perception of sexual violence has been explored very marginally. Our main objective with this study was to explore, by means of a representative sample of the general population (N = 2,465), the relationship between the acceptability of sexual violence and demographic, behavioral, and attitudinal factors in Spain. The variable with the highest impact on the outcome was sexism, followed by knowledge of the most common type of victim-perpetrator relationship, age, perceived frequency of false complaints, and educational background. Other variables such as sex, country of birth, attitudes toward the consumption of prostitution, or opinions regarding prevention of sexual violence were also significant. A better understanding of the factors influencing public attitudes toward sexual violence would be useful to guide prevention efforts.

Influence of Intimate Partner Violence Severity on the Help-Seeking Strategies of Female Victims and the Influence of Social Reactions to Violence Disclosure on the Process of Leaving a Violent Relationship.

This article uses data from the 2015 Spanish Survey on Violence Against Women, a nationally representative survey of 10,171 women aged 16 or above, to analyze the relationship between the severity of intimate partner violence and formal and informal help-seeking strategies, the link between the severity of abuse and the reasons for not seeking formal help, and the influence of social reactions to violence disclosure on the process of leaving a violent relationship. The results show that in Spain, many abused women disclose violence and seek help. However, the severity of the violence strongly determines their help-seeking strategies, especially the search for formal help. Women who experienced less severe incidents tended to minimize their importance and did not seek formal help. For informal help, the differences were smaller, and a high proportion of women talked about the abuse with someone within their social environment, regardless of the severity of the suffered violence. A supportive reaction to violence disclosure had a strong and positive influence on the process of leaving the abusive relationship. The implications of these findings for the design of public policies, education, and awareness-raising campaigns are discussed.

Frequency-resolved Monte Carlo.

We adapt the Quantum Monte Carlo method to the cascaded formalism of quantum optics, allowing us to simulate the emission of photons of known energy. Statistical processing of the photon clicks thus collected agrees with the theory of frequency-resolved photon correlations, extending the range of applications based on correlations of photons of prescribed energy, in particular those of a photon-counting character. We apply the technique to autocorrelations of photon streams from a two-level system under coherent and incoherent pumping, including the Mollow triplet regime where we demonstrate the direct manifestation of leapfrog processes in producing an increased rate of two-photon emission events.

First observation of the quantized exciton-polariton field and effect of interactions on a single polariton.

Polaritons are quasi-particles that originate from the coupling of light with matter and that demonstrate quantum phenomena at the many-particle mesoscopic level, such as Bose-Einstein condensation and superfluidity. A highly sought and long-time missing feature of polaritons is a genuine quantum manifestation of their dynamics at the single-particle level. Although they are conceptually perceived as entangled states and theoretical proposals abound for an explicit manifestation of their single-particle properties, so far their behavior has remained fully accounted for by classical and mean-field theories. We report the first experimental demonstration of a genuinely quantum state of the microcavity polariton field, by swapping a photon for a polariton in a two-photon entangled state generated by parametric downconversion. When bringing this single-polariton quantum state in contact with a polariton condensate, we observe a disentangling with the external photon. This manifestation of a polariton quantum state involving a single quantum unlocks new possibilities for quantum information processing with interacting bosons.

The Consequences of Intimate Partner Violence on Health: A Further Disaggregation of Psychological Violence-Evidence From Spain.

Using a nationally representative sample of 10,171 women, this study examines the association between current and previous intimate partner violence and current health status. Current physical or sexual violence was associated with the highest likelihood of reporting health outcomes, followed by current emotional or economic abuse. Current controlling behavior increased the odds of reporting poor health whereas previous controlling behavior has less effect on current health. Controlling behavior alone often is the first expression of mistreatment. If health professionals could identify violence at this early stage, long-term effects on women's health could be minimized. The implications for health of the cumulative effects of violence and of its timing are discussed.

Non-partner sexual violence against women in Spain: lifetime prevalence, perpetrators and consequences on mental health.

Background: Research on sexual violence by non-partners based on representative samples is scarce. The objectives of the study were (i) to analyse the prevalence of different forms of non-partner sexual violence in Spain and their perpetrators, (ii) to analyse the consequences of non-partner sexual violence on mental health and (iii) to estimate the percentage of rapes that are reported to the police. Methods: Data from the 2015 Spanish Survey on Violence against Women, a nationally representative sample of 10 171 women, were used. Three mutually exclusive categories of non-partner sexual violence were created to measure the effects of violence on health. Logistic regression models were fitted. Results: The lifetime prevalence of non-partner sexual violence was 7.2%. All the categories of non-partner sexual violence were strongly associated with the different health outcomes. Rape increased the likelihood of reporting anxiety [odds ratio, OR: 3.77 (2.65-5.37)], sadness because of feelings of worthlessness [OR: 3.31 (2.32-4.73)] and the desire to cry without reason [OR: 3.46 (2.45-4.89)] more than 3-fold. The relationship of the victim with the perpetrator varied by the type of sexual victimization. Less than 6% of rapes were reported to the police in 2014. Conclusions: All forms of non-partner sexual violence, from unwanted sexual touching to rape, can lead to a multitude of mental health consequences. A public health approach to addressing this violence is needed.

Coherent Generation of Nonclassical Light on Chip via Detuned Photon Blockade.

The on-chip generation of nonclassical states of light is a key requirement for future optical quantum hardware. In solid-state cavity quantum electrodynamics, such nonclassical light can be generated from self-assembled quantum dots strongly coupled to photonic crystal cavities. Their anharmonic strong light-matter interaction results in large optical nonlinearities at the single photon level, where the admission of a single photon into the cavity may enhance (photon tunneling) or diminish (photon blockade) the probability for a second photon to enter the cavity. Here, we demonstrate that detuning the cavity and quantum-dot resonances enables the generation of high-purity nonclassical light from strongly coupled systems. For specific detunings we show that not only the purity but also the efficiency of single-photon generation increases significantly, making high-quality single-photon generation by photon blockade possible with current state-of-the-art samples.

Level of HER2 gene amplification predicts response and overall survival in HER2-positive advanced gastric cancer treated with trastuzumab.

PURPOSE: Previous studies have highlighted the importance of an appropriate human epidermal growth factor receptor 2 (HER2) evaluation for the proper identification of patients eligible for treatment with anti-HER2 targeted therapies. Today, the relationship remains unclear between the level of HER2 amplification and the outcome of HER2-positive gastric cancer treated with first-line chemotherapy with trastuzumab. The aim of this study was to determine whether the level of HER2 gene amplification determined by the HER2/CEP17 ratio and HER2 gene copy number could significantly predict some benefit in overall survival and response to therapy in advanced gastric cancer treated with trastuzumab-based chemotherapy. PATIENTS AND METHODS: Ninety patients with metastatic gastric cancer treated with first-line trastuzumab-based chemotherapy were studied. The optimal cutoff values for HER2/CEP17 ratio and HER2 gene copy number (GCN) for discriminating positive results in terms of response and prolonged survival were determined using receiver operating characteristic curves analyses. RESULTS: In this study, a median HER2/CEP17 ratio of 6.11 (95% CI, 2.27 to 21.90) and a median HER2 gene copy number of 11.90 (95% CI, 3.30 to 43.80) were found. A mean HER2/CEP17 ratio of 4.7 was identified as the optimal cutoff value discriminating sensitive and refractory patients (P = .005). Similarly, the optimal cutoff for predicting survival longer than 12 months was 4.45 (P = .005), and for survival longer than 16 months was 5.15 (P = .004). For HER2 GCN, the optimal cutoff values were 9.4, 10.0, and 9.5, respectively (P = .02). CONCLUSION: The level of HER2 gene amplification significantly predicts sensitivity to therapy and overall survival in advanced gastric cancer treated with trastuzumab-based chemotherapy.

Strong coupling of quantum dots in microcavities.

We show that strong coupling (SC) of light and matter as it is realized with quantum dots in microcavities differs substantially from the paradigm of atoms in optical cavities. The type of pumping used in semiconductors yields new criteria to achieve SC, with situations where the pump hinders, or on the contrary, favors it. We analyze one of the seminal experimental observation of SC of a quantum dot in a pillar microcavity [Reithmaier, Nature (London) 432, 197 (2004)10.1038/nature02969] as an illustration of our main statements.

Investigación sobre una técnica proyectiva mediante el uso de dibujos colectivos / A projective technical investigation by means of collective drawings

Describimos el uso de dibujos colectivos como la posibilidad de utilizar un recurso plástico, una técnica de acción y un medio proyectivo para esclarecer, fortalecer y dilucidar hipótesis formuladas con respecto al proceso grupal, en cuanto a su desarrollo, avances, desviaciones, generación de síntomas y conciencia de sí mismo. Es la posibilidad de "ver" con más claridad tanto para los coordinadores del grupo como para los participantes del mismo. En estos últimos, el dibujo llega a representar la evidencia de fenómenos grupales que no habían sido hecho explicitos aún, o bien, que no se había expuesto con palabras por alguna razón; sirven como la representación-cosa que por medio de asociaciones generarán sentidos

El año más dificil. Aspectos emocionales de la formación psiquiátrica / The most difficult year. Emotional aspects of the psyquiatric formation

Se describe la perspectiva de la experiencia propia y de varios residentes, las situaciones generadoras de ansiedad a la que los residentes de primer año en la especialización de psiquiatría, están sujetos. En donde las primeras semanas se observan actitudes de curiosidad y temor hacia los pacientes, ansiedad, se acentúa la duda en cuanto al rol de médico como experto. A la segunda mitad del año sigue con un esfuerzo diario por recuperar la identidad profesional en ese momento se identifica más con su paciente. Más adelante a fines del primer año aparece el reconocimiento de las limitaciones del conocimiento psiquiátrico trayendo desilusión e inestabilidad, precedido por un periódo de vagas insatisfacciones y quejas. El aprendizaje es doloroso porque implica el reconocimiento en uno mismo de todas esas partes locas, horribles que ocultan o que estan en otra gente