Eletroconvulsoterapia no tratamento da psicose puerperal

A psicose puerperal (PP) é um quadro clínico exuberante, com uma frequência estimada de 1 caso por cada 1.000 puerpérios, e que tem sido associado com maior consistência ao espectro bipolar. A evidência científica disponível é escassa, nomeadamente no respeitante à orientação terapêutica. Os autores apresentam o caso clínico de uma mulher primípara de 28 anos, sem antecedentes psiquiátricos, que iniciou nas primeiras semanas de puerpério um quadro psicótico florido, composto por agitação psicomotora, confusão, desorganização do pensamento e comportamento, sintomatologia psicótica e insônia grave. Por ausência de resposta ao tratamento farmacológico, houve recurso à eletroconvulsoterapia (ECT), com melhoria clínica rápida e evidente. Nesse contexto, os autores realizaram uma apreciação da literatura e evidência referentes ao uso de ECT na psicose puerperal.

Errores en sistemas de procesamiento de datos debido a eventos transitorios en interfaces analógicas: aportes a la mitigación de los mismos. Errors in data processing systems due to single transient events affecting analog interfaces: contributions to their mitigation.

Los eventos transitorios únicos analógicos (ASET, Analog Single Event Transient) se producen debido a la interacción de un ión pesado o un protón de alta energía con un dispositivo sensible de un circuito analógico. La interacción del ión con un transistor bipolar o de efecto de campo MOS induce pares electrón-hueco que provocan picos que pueden propagarse a la salida del componente analógico provocando transitorios que pueden inducir fallas en el nivel sistema. Los problemas más graves debido a este tipo de fenómeno se dan en el medioambiente espacial, muy rico en iones pesados. Casos típicos los constituyen las computadoras de a bordo de satélites y otros artefactos espaciales. Sin embargo, y debido a la continua contracción de dimensiones de los transistores (que trae aparejado un aumento de sensibilidad), este fenómeno ha comenzado a observarse a nivel del mar, provocado fundamentalmente por el impacto de neutrones atmosféricos. Estos efectos pueden provocar severos problemas a los sistemas informáticos con interfaces analógicas desde las que obtienen datos para el procesamiento y se han convertido en uno de los problemas más graves a los que tienen que hacer frente los diseñadores de sistemas de alta escala de integración. Casos típicos son los Sistemas en Chip que incluyen módulos de procesamiento de altas prestaciones como las interfaces analógicas.El proyecto persigue como objetivo general estudiar la susceptibilidad de sistemas informáticos a ASETs en sus secciones analógicas, proponiendo estrategias para la mitigación de los errores.Como objetivos específicos se pretende: -Proponer nuevos modelos de ASETs basados en simulaciones en el nivel dispositivo y resueltas por el método de elementos finitos.-Utilizar los modelos para identificar las secciones más propensas a producir errores y consecuentemente para ser candidatos a la aplicación de técnicas de endurecimiento a radiaciones.-Utilizar estos modelos para estudiar la naturaleza de los errores producidos en sistemas de procesamiento de datos.-Proponer soluciones novedosas para la mitigación de estos efectos en los mismos circuitos analógicos evitando su propagación a las secciones digitales.-Proponer soluciones para la mitigación de los efectos en el nivel sistema.Para llevar a cabo el proyecto se plantea un procedimiento ascendente para las investigaciones a realizar, comenzando por descripciones en el nivel físico para posteriormente aumentar el nivel de abstracción en el que se encuentra modelado el circuito. Se propone el modelado físico de los dispositivos MOS y su resolución mediante el Método de Elementos Finitos. La inyección de cargas en las zonas sensibles de los modelos permitirá determinar los perfiles de los pulsos de corriente que deben inyectarse en el nivel circuito para emular estos efectos. Estos procedimientos se realizarán para los distintos bloques constructivos de las interfaces analógicas, proponiendo estrategias de mitigación de errores en diferentes niveles.Los resultados esperados del presente proyecto incluyen hardware para detección de errores y tolerancia a este tipo de eventos que permitan aumentar la confiabilidad de sistemas de tratamiento de la información, así como también nuevos datos referentes a efectos de la radiación en semiconductores, nuevos modelos de fallas transitorias que permitan una simulación de estos eventos en el nivel circuito y la determinación de zonas sensibles de interfaces analógicas típicas que deben ser endurecidas para radiación.

Morfologia do Mycobacterium leprae hominis e do M. leprae muris: estudo baseado na microscopia electrônica e de contraste de fases

Hansen's Bacillus: By electron microscopy this bacillus shows membrane and halo, this being more visible when sorrounding the globi or bundles of bacilli; shows, also, free granules of various sizes which were before considered as dust of the dyes; shows external granules bound with the membrane and some times branching. By phases contrast microscopy examining leproma suspensions and subcataneous lymph at 400 x we saw many free granules with intense rotatory movement; granulated bacilli with screw, skip or stroke motion, producing slow progressive motion. All such elementes are surrounded by a halo, corresponding to the classical gloea. By a patient and delayed examination we were able to see that the internal granules are motile and help the progression of the bacilli, giving the impression that the cytoplasm is liquid. By a lasting observation we could see the larger granules form prolapse, like a pseudopode and abandon the bacilli and going in very rapid rotatory movement. There are branched bacilli; there are pedunculated fred granules like comets. The addition of a drop of formol at the preparation stops all movements. Stefansky's Bacillus: Repeated examination by RCA electron microscope, type EMU-25 of fresh suspensions of rat lepromas, led us to confirm the close relationship between human and murine leprosy agents. We examined also material from carabo (Lepra bubalorum) from Java, but due to fixation, the material was unsuitable for comparative studies. The Stefansky's bacilli showed also emmbranes and halos, internal or external granules (smaller than those of Hansen's bacillus). The bacilli shaded by chromium look thicker and shorter than those of Hansen. Due to electron bombardment both, Hansen's and Stefansky's baccilli suffer considerable alterations in their structure, showing black barrs of chromatin condensation at their extremities as also in their centers. By phase microscopy the Stefansky's bacilli showed elements with 1, 2 (bipolar), 3 or more internal small granules, developing identical movements as those of Hansen. The globi seem to be non-motile but the free bacilli appearing around the globi show intense movement. At 1000 x the examination is less satisfactory than at 400 x. The addition of formol solution in the preparation suppresses all movements, even the brownian, but the material becomes more suitable for the study of static morphology of the bacilli. CONCLUSION - The electron and phases contrast microscopy of leprous material from different types and phases of the disease may explain some of the unknown aspects of the biology and morphology of the bacilli.

Xarxes virtuals de solidaritat: el cas del grup d'autoajuda Bipolarweb

Per a poder comprendre la dimensió de les possibles transformacions que Internet pot comportar, cal investigar els usos concrets de què es o ha estat objecte. En definitiva, cal realitzar investigacions empíriques que aportin informació sobre qui usa Internet, en quines circumstàncies i amb quins objectius. En aquest context, s’ha iniciat l’anàlisi en profunditat d’un cas específic de comunitat virtual de suport social creada per una persona afectada pel trastorn bipolar. L’objectiu d’una comunitat d’autoajuda virtual és proporcionar informació i recolzament emocional a través d’Internet. Mitjançant una metodologia qualitativa s’ha realitzat l’observació del fòrum virtual que penja de la pàgina web “Bipoloarweb.com”. En les investigacions del fenomen dels grups d’autoajuda a Internet, sovint s’ha destacat que a diferència dels grups ‘presencials’, aquests només poden aportar recolzament emocional i informatiu als seus membres. El tipus de recolzament instrumental o altre tipus d’assistència física, en canvi, no és possible en els casos virtuals. Els primers resultats de la recerca invaliden aquesta afirmació general ja que s’ha pogut observar episodis diferents d’ajut instrumental. En relació a la gestió d’informació i producció de coneixement, ja es pot avançar algunes qüestions interessants. En primer lloc, la quantitat i el detall de la informació que en el fòrum circula sobre el trastorn Bipolar. La majoria d’aquests coneixements, però, sorgeixen directament de compartir l’experiència diària entre els membres del grup. Tot això permet avançar la següent hipòtesi de treball pel futur: a més a més de suport emocional i instrumental, aquest grup ‘empodera’ el seus membres? Si la resposta fos positiva, el nostre cas tindria semblances amb altres fenòmens com son les associacions de malalts.

Métodos de extracción de parámetros de un circuito equivalente de pequeña señal para transistores LDMOS de potencia para aplicaciones de RF

En la actualidad, la gran cantidad de aplicaciones que surgen dentro del ámbito de la radiofrecuencia hacen que el desarrollo de dispositivos dentro de este campo sea constante. Estos dispositivos cada vez requieren mayor potencia para frecuencias de trabajo elevadas, lo que sugiere abrir vías de investigación sobre dispositivos de potencia que ofrezcan los resultados deseados para altas frecuencias de operación (GHz). Dentro de este ámbito, el objetivo principal de este proyecto es el de realizar un estudio sobre este tipo de dispositivos, siendo el transistor LDMOS el candidato elegido para tal efecto, debido a su buen comportamiento en frecuencia para tensiones elevadas de funcionamiento.

Simulations of parasitic and intrinsic capacitances related to Multiple-Gate-Field-Effect Transistor architectures

Report for the scientific sojourn carried out at the Université Catholique de Louvain, Belgium, from March until June 2007. In the first part, the impact of important geometrical parameters such as source and drain thickness, fin spacing, spacer width, etc. on the parasitic fringing capacitance component of multiple-gate field-effect transistors (MuGFET) is deeply analyzed using finite element simulations. Several architectures such as single gate, FinFETs (double gate), triple-gate represented by Pi-gate MOSFETs are simulated and compared in terms of channel and fringing capacitances for the same occupied die area. Simulations highlight the great impact of diminishing the spacing between fins for MuGFETs and the trade-off between the reduction of parasitic source and drain resistances and the increase of fringing capacitances when Selective Epitaxial Growth (SEG) technology is introduced. The impact of these technological solutions on the transistor cut-off frequencies is also discussed. The second part deals with the study of the effect of the volume inversion (VI) on the capacitances of undoped Double-Gate (DG) MOSFETs. For that purpose, we present simulation results for the capacitances of undoped DG MOSFETs using an explicit and analytical compact model. It monstrates that the transition from volume inversion regime to dual gate behaviour is well simulated. The model shows an accurate dependence on the silicon layer thickness,consistent withtwo dimensional numerical simulations, for both thin and thick silicon films. Whereas the current drive and transconductance are enhanced in volume inversion regime, our results show thatintrinsic capacitances present higher values as well, which may limit the high speed (delay time) behaviour of DG MOSFETs under volume inversion regime.

Tracking of Stepwise Ablation of Persistent Atrial Fibrillation using Synchronization of nearby Electrogams

Intracardiac organization indices such as atrial fibril- lation (AF) cycle length (AFCL) have been used to track the efficiency of stepwise catheter ablation (step-CA) of long-standing persistent AF (pers-AF), however, with lim- ited success. The timing between nearby bipolar intracar- diac electrograms (EGMs) reflects the spatial dynamics of wavelets during AF. The extent of synchronization between EGMs is an indirect measure of AF spatial organization. The synchronization between nearby EGMs during step- CA of pers-AF was evaluated using new indices based on the cross-correlation. The first one (spar(W)) quantifies the sparseness of the cross-correlation of local activation times. The second one (OI(W)) reflects the local concen- tration around the largest peak of the cross-correlation. By computing their relative evolution during step-CA until AF termination (AF-term), we found that OI(W) appeared su- perior to AFCL and spar(W) to track the effect of step-CA "en route" to AF-term.

Analyzing the effects of transient faults into applications

As computer chips implementation technologies evolve to obtain more performance, those computer chips are using smaller components, with bigger density of transistors and working with lower power voltages. All these factors turn the computer chips less robust and increase the probability of a transient fault. Transient faults may occur once and never more happen the same way in a computer system lifetime. There are distinct consequences when a transient fault occurs: the operating system might abort the execution if the change produced by the fault is detected by bad behavior of the application, but the biggest risk is that the fault produces an undetected data corruption that modifies the application final result without warnings (for example a bit flip in some crucial data). With the objective of researching transient faults in computer system’s processor registers and memory we have developed an extension of HP’s and AMD joint full system simulation environment, named COTSon. This extension allows the injection of faults that change a single bit in processor registers and memory of the simulated computer. The developed fault injection system makes it possible to: evaluate the effects of single bit flip transient faults in an application, analyze an application robustness against single bit flip transient faults and validate fault detection mechanism and strategies.

A mega-analysis of genome-wide association studies for major depressive disorder.

Prior genome-wide association studies (GWAS) of major depressive disorder (MDD) have met with limited success. We sought to increase statistical power to detect disease loci by conducting a GWAS mega-analysis for MDD. In the MDD discovery phase, we analyzed more than 1.2 million autosomal and X chromosome single-nucleotide polymorphisms (SNPs) in 18 759 independent and unrelated subjects of recent European ancestry (9240 MDD cases and 9519 controls). In the MDD replication phase, we evaluated 554 SNPs in independent samples (6783 MDD cases and 50 695 controls). We also conducted a cross-disorder meta-analysis using 819 autosomal SNPs with P<0.0001 for either MDD or the Psychiatric GWAS Consortium bipolar disorder (BIP) mega-analysis (9238 MDD cases/8039 controls and 6998 BIP cases/7775 controls). No SNPs achieved genome-wide significance in the MDD discovery phase, the MDD replication phase or in pre-planned secondary analyses (by sex, recurrent MDD, recurrent early-onset MDD, age of onset, pre-pubertal onset MDD or typical-like MDD from a latent class analyses of the MDD criteria). In the MDD-bipolar cross-disorder analysis, 15 SNPs exceeded genome-wide significance (P<5 × 10(-8)), and all were in a 248 kb interval of high LD on 3p21.1 (chr3:52 425 083-53 822 102, minimum P=5.9 × 10(-9) at rs2535629). Although this is the largest genome-wide analysis of MDD yet conducted, its high prevalence means that the sample is still underpowered to detect genetic effects typical for complex traits. Therefore, we were unable to identify robust and replicable findings. We discuss what this means for genetic research for MDD. The 3p21.1 MDD-BIP finding should be interpreted with caution as the most significant SNP did not replicate in MDD samples, and genotyping in independent samples will be needed to resolve its status.

The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: trauma and early psychotic mania.

OBJECTIVE: Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania. METHODS: Traumatic events were retrospectively evaluated from patient files in a sample of 65 participants who had experienced first episode psychotic mania. Participants were aged between 15 and 28 years and were treated at a specialised early psychosis service. Clinical outcomes were measured by a variety of symptomatic and functioning scales at the 12-month time-point. RESULTS: Direct-personal traumatic experiences prior to the onset of psychotic mania were reported by 48% of the sample. Participants with past direct-personal trauma had significantly higher symptoms of mania (p=0.02), depression (p=0.03) and psychopathology (p=0.01) 12 months following their first episode compared to participants without past direct-personal trauma, with medium to large effects observed. After adjusting for baseline scores, differences in global functioning (as measured by the Global Assessment of Functioning scale) were non-significant (p=0.05); however, participants with past direct-personal trauma had significantly poorer social and occupational functioning (p=0.04) at the 12-month assessment with medium effect. CONCLUSIONS: Past direct-personal trauma may predict poorer symptomatic and functional outcomes after first episode psychotic mania. Limitations include that the findings represent individuals treated at a specialist early intervention centre for youth and the retrospective assessment of traumatic events may have been underestimated.

TRPM1 is mutated in patients with autosomal-recessive complete congenital stationary night blindness.

Night vision requires signaling from rod photoreceptors to adjacent bipolar cells in the retina. Mutations in the genes NYX and GRM6, expressed in ON bipolar cells, lead to a disruption of the ON bipolar cell response. This dysfunction is present in patients with complete X-linked and autosomal-recessive congenital stationary night blindness (CSNB) and can be assessed by standard full-field electroretinography (ERG), showing severely reduced rod b-wave amplitude and slightly altered cone responses. Although many cases of complete CSNB (cCSNB) are caused by mutations in NYX and GRM6, in approximately 60% of the patients the gene defect remains unknown. Animal models of human diseases are a good source for candidate genes, and we noted that a cCSNB phenotype present in homozygous Appaloosa horses is associated with downregulation of TRPM1. TRPM1, belonging to the family of transient receptor potential channels, is expressed in ON bipolar cells and therefore qualifies as an excellent candidate. Indeed, mutation analysis of 38 patients with CSNB identified ten unrelated cCSNB patients with 14 different mutations in this gene. The mutation spectrum comprises missense, splice-site, deletion, and nonsense mutations. We propose that the cCSNB phenotype in these patients is due to the absence of functional TRPM1 in retinal ON bipolar cells.

Control de instrumentos mediante el bus GPIB programado con MATLAB

El proyecto que se expone a continuación está dedicado al control de instrumentos mediante el bus de instrumentación GPIB programado con el software Matlab. Está dividido en dos partes. La primera, será llevada a cabo en el laboratorio de docencia y el objetivo será controlar el osciloscopio y el generador de funciones. Como ejemplo del control realizado se desarrollará una aplicación que permitirá obtener el diagrama de Bode de módulo de cualquier sistema electrónico. La segunda parte será llevada a cabo en el laboratorio de investigación y el objetivo será controlar el analizador de semiconductores. En este caso, la aplicación desarrollada permitirá la realización de medidas para la caracterización de transistores. Las aplicaciones de ambas partes estarán realizadas mediante una interfaz gráfica de usuario diseñada con la herramienta GUIDE de Matlab.

Diagnostic interview for genetic studies (DIGS): inter-rater and test-retest reliability of the French version.

The National Institute of Mental Health developed the semi-structured Diagnostic Interview for Genetic Studies (DIGS) for the assessment of major mood and psychotic disorders and their spectrum conditions. The DIGS was translated into French in a collaborative effort of investigators from sites in France and Switzerland. Inter-rater and test-retest reliability of the French version have been established in a clinical sample in Lausanne. Excellent inter-rater reliability was found for schizophrenia, bipolar disorder, major depression, and unipolar schizoaffective disorder while fair inter-rater reliability was demonstrated for bipolar schizoaffective disorder. Using a six-week test-retest interval, reliability for all diagnoses was found to be fair to good with the exception of bipolar schizoaffective disorder. The lower test-retest reliability was the result of a relatively long test-retest interval that favored incomplete symptom recall. In order to increase reliability for lifetime diagnoses in persons not currently affected, best-estimate procedures using additional sources of diagnostic information such as medical records and reports from relatives should supplement DIGS information in family-genetic studies. Within such a procedure, the DIGS appears to be a useful part of data collection for genetic studies on major mood disorders and schizophrenia in French-speaking populations.

Desarrollo de software para el procesado numérico en tarjetas gráficas

Debido al gran número de transistores por mm2 que hoy en día podemos encontrar en las GPU convencionales, en los últimos años éstas se vienen utilizando para propósitos generales gracias a que ofrecen un mayor rendimiento para computación paralela. Este proyecto implementa el producto sparse matrix-vector sobre OpenCL. En los primeros capítulos hacemos una revisión de la base teórica necesaria para comprender el problema. Después veremos los fundamentos de OpenCL y del hardware sobre el que se ejecutarán las librerías desarrolladas. En el siguiente capítulo seguiremos con una descripción del código de los kernels y de su flujo de datos. Finalmente, el software es evaluado basándose en comparativas con la CPU.

Encoding dysfunctions in a dynamic-static paradigm for visuospatial working memory in first-episode psychosis patients: a 2-year follow-up study.

Aim: To investigate static and dynamic visuospatial working memory (VSWM) processes in first-episode psychosis (FEP) patients and explore the validity of such measures as specific trait markers of schizophrenia. Methods: Twenty FEP patients and 20 age-, sex-, laterality- and education-matched controls carried out a dynamic and static VSWM paradigm. At 2-year follow up 13 patients met Diagnostic and Statistical Manual (of Mental Health Disorders) - Fourth Edition (DSM-IV) criteria for schizophrenia, 1 for bipolar disorder, 1 for brief psychotic episode and 5 for schizotypal personality disorder. Results: Compared with controls, the 20 FEP patients showed severe impairment in the dynamic VSWM condition but much less impairment in the static condition. No specific bias in stimulus selection was detected in the two tasks. Two-year follow-up evaluations suggested poorer baseline scores on the dynamic task clearly differentiated the 13 FEP patients who developed schizophrenia from the seven who did not. Conclusions: Results suggest deficits in VSWM in FEP patients. Specific exploratory analyses further suggest that deficit in monitoring-manipulation VSWM processes, especially involved in our dynamic VSWM task, can be a reliable marker of schizophrenia.