Early onset obsessive-compulsive disorder with and without tics

Introduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations. Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated. Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the early onset group (EOG): before 11 years of age, 75 patients had an intermediate onset (IOG), and 95 patients were from the late onset group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale; and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression. © MBL Communications Inc.

Necrotizing soft tissue infection of the breast: Case report and literature review

Background: Necrotizing soft tissue infection (NSTI) is characterized by progressive infectious gangrene of the skin and subcutaneous tissue. Its treatment involves intensive care, broad-spectrum antibiotic therapy, and full debridement. Methods: We present two cases of NSTI of the breast, adding these cases to the 14 described in the literature, reviewing the characteristics and evolution of all cases. Case Report: On the fourth day after mastectomy, a 59-year-old woman with ulcerated breast cancer developed Type I NSTI caused by Pseudomonas aeruginosa, which had a favorable evolution after debridement and broad-spectrum antibiotics. The second patient was a 57-year-old woman submitted to a mastectomy and axillary dissection, who had recurrent seromas. On the 32nd post-operative day, after a seroma puncture, she developed Type II NSTI caused by β-hemolytic streptococci. She developed sepsis and died on the tenth day after debridement, intensive care, and broad-spectrum antibiotics. The cases are the first description of breast NSTI after mammary seroma aspiration and the first report of this condition caused by P. aeruginosa. Conclusion: Necrotizing soft tissue infection is rare in breast tissue. It frequently is of Type II, occurring mainly after procedures in patients with breast cancer. The surgeon's participation in controlling the focus of the infection is of fundamental importance, and just as important are broad-spectrum antibiotic therapy and support measures, such as maintenance of volume, correction of electrolytic disorders, and treatment of sepsis and septic shock. Once the infection has been brought under control, skin grafting or soft tissue flaps can be considered. The mortality rate in breast NSTI is 18.7%, all deaths being in patients with the fulminant Type II form. Surgical oncologists need to be alert to the possibility of this rare condition. © 2012, Mary Ann Liebert, Inc.

Impulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcome

Although traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p < 0.001), longer duration of obsessions (p = 0.017), greater severity of symmetry/ordering (p < 0.001), contamination/cleaning (p < 0.001) and hoarding (p = 0.002) symptoms, and comorbid intermittent explosive disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. © 2012 Elsevier Ltd.

Detecção de faltas em sistemas de distribuição de energia elétrica usando dispositivos programáveis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Metodologia para análise e interpretação de alarmes em tempo real de sistemas de distribuição de energia elétrica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Experimentos de mineração de dados aplicados a sistemas scada de usinas hidrelétricas

O atual modelo do setor elétrico brasileiro permite igualdade de condições a todos os agentes e reduz o papel do Estado no setor. Esse modelo obriga as empresas do setor a melhorarem cada vez mais a qualidade de seu produto e, como requisito para este objetivo, devem fazer uso mais efetivo da enorme quantidade de dados operacionais que são armazenados em bancos de dados, provenientes da operação dos seus sistemas elétricos e que tem nas Usinas Hidrelétricas (UHE) a sua principal fonte de geração de energia. Uma das principais ferramentas para gerenciamento dessas usinas são os sistemas de Supervisão, Controle e Aquisição de Dados (Supervisory Control And Data Acquisition - SCADA). Assim, a imensa quantidade de dados acumulados nos bancos de dados pelos sistemas SCADA, muito provavelmente contendo informações relevantes, deve ser tratada para descobrir relações e padrões e assim ajudar na compreensão de muitos aspectos operacionais importantes e avaliar o desempenho dos sistemas elétricos de potência. O processo de Descoberta de Conhecimento em Banco de Dados (Knowledge Discovery in Database - KDD) é o processo de identificar, em grandes conjuntos de dados, padrões que sejam válidos, novos, úteis e compreensíveis, para melhorar o entendimento de um problema ou um procedimento de tomada de decisão. A Mineração de Dados (ou Data Mining) é o passo dentro do KDD que permite extrair informações úteis em grandes bases de dados. Neste cenário, o presente trabalho se propõe a realizar experimentos de mineração de dados nos dados gerados por sistemas SCADA em UHE, a fim de produzir informações relevantes para auxiliar no planejamento, operação, manutenção e segurança das hidrelétricas e na implantação da cultura da mineração de dados aplicada a estas usinas.

Epidemiologia da leishmaniose tegumentar no município de Juruti, Pará

A leishmaniose tegumentar (LT) encontra-se em expansão no Estado do Pará, Brasil. Juruti é um dos 143 municípios desse Estado e atualmente cenário de grandes transformações ambientais devido à mineração de bauxita, o que poderá influenciar o padrão de transmissão. Objetivo: Este estudo buscou elucidar aspectos epidemiológicos relevantes para o controle da LT em Juruti. Materiais e Métodos: A frequência de LT e o perfil dos pacientes no hospital municipal "Francisco Barros" foram determinados de janeiro a dezembro/2007. Espécies de flebotomíneos silvestres existentes no entorno de uma área de prospecção da bauxita foram também descritas, durante levantamento entomológico em janeiro/2008 (armadilha Shannon/18h às 20h/2 noites). Em 21 indivíduos, portadores de lesão cutânea suspeita de LT, biópsias de pele foram realizadas entre fevereiro e junho de 2007. Neste grupo procedeu-se ao diagnóstico parasitológico (esfregaço corado e cultura), molecular e teste intradérmico de Montenegro. Utilizaram-se sondas de DNA ribossomal (PCR-SSUrDNA) gênero específicas (S4, S12; S17, S18) e de G6PD, para distinguir o subgênero Viannia (ISVC, ISVA: ISVC, ISVG) e a espécie L. (V.) braziliensis (ISVC, ISVA; ISVC, ISVB). Resultados: No ano de 2007 foram confirmados 42 casos novos de LT, com média mensal inferior a quatro (3,5 ± 0,8), maior frequência em julho (11) e menor em junho e novembro (0). A maioria dos pacientes foi de homens (41/42, 98%) com menos de 20 anos (<10 anos: 30%; 10-20: 57%; 20-40: 12%). A maioria também residia em localidades rurais (33/42, 79%), incluindo áreas impactadas pela mineração (19/42, 45%), e exercia atividades de risco (28/42, 67%). Doze eram funcionários de empresas (29%). A análise molecular das 21 amostras identificou 12 resultados positivos para o gênero Leishmania (57%), sendo 11 (52%) parasitologicamente confirmados. A PCRG6PD identificou 75% das amostras como sendo L. (V.) braziliensis. As demais (3/12, 25%) não hibridizaram com os oligonucleotídeos da PCR-G6PD e, por isso, os produtos da reação de nested-PCR SSUrDNA foram clonados e sequenciados, confirmando que se tratavam de Leishmania (Viannia) sp. Apenas 9/12 (75%) casos confirmados pelos métodos parasitológico e/ou olecular tiveram reações de hipersensibilidade tardia em resposta ao antígeno de Montenegro, cujos diâmetros variaram de 7 a 40mm (16,3 ± 3,2). Capturaram-se 105 flebotomíneos de 13 espécies nas seguintes frequências: 1- Lutzomyia (Ps.) geniculata (23, 22%), 2- Lutzomyia (Ps.) paraensis (21, 20%), 3- Lutzomyia (Ps.) complexa (18, 17%), 4-Lutzomyia (Ps.) davisi (10, 10%), 5- Lutzomyia (N.) flaviscutellata (13, 13%) e outras oito espécies (20, 18%). Discussão: Espécies de Leishmania do subgênero Viannia, sobretudo L. (V.) braziliensis predominam em Juruti, o que é compatível com o extenso diâmetro das reações cutâneas observadas ao antígeno de Montenegro e com os relatos comuns de persistência e recidiva, apesar do tratamento específico. Entre os flebotomíneos antropófilos destacam-se L. (Ps.) complexa (17%) e L. (Ps.) flaviscutellata (13%) por serem vetores de L. (V.) braziliensis e L. (L.) amazonensis respectivamente, associadas às formas severas da LT humana. Conclusão: Medidas de controle em Juruti devem priorizar a redução da morbidade, diagnóstico precoce, busca ativa de LT humana, vigilância entomológica e de microambientes no entorno da área de impacto de mineração.

Sistema para navegação de robôs móveis e interação humano-robô baseada em comandos de voz

This project is comprised by an interactive mobile robotics’ environment, focused in human-robot interaction. The system was developed to work in a smartphone, with Android operating system, embedded in a small size mobile robot. Information provided by the smartphone’s camera and microp hone, as well as by proximity sensors embedded in the robot, is used as inputs of a control architecture, implemented in software. It is a behavior-based and receptive to human commands control architecture, to assist the robot’s navigation. The robot is controlled by its own behaviors or by commands em it ted by humans

Efeito Agudo em Parâmetros Cinéticos em Tarefas Estáticas e Dinâmicas devido ao Uso de Palmilhas Proprioceptivas

Pós-graduação em Engenharia Mecânica - FEG

Aquisição da informação visual: controle da postura e do olhar

Postural control is needed to perform various daily activities, from staying in one posture, standing, to sports situations. Many studies have shown that sensory systems help to maintain posture stable; acquisition of perceptual information, particularly through head and eye movements, allows static and dynamic equilibrium. Research related to both motor behavior and physical activities such as gymnastics have contributed to a better understanding of complexities involved in human postural control. The purpose of this study was to review the related literature, searching for possible answers on how everyday and sports actions are performed, with respect to the control and maintenance of posture. Its focus was on how the human body acquires information from the sensory systems, vision in special, and how this information acts to support the control of posture and gaze

VS - Bovine Tuberculosis (Mycobacterium bovis) Surveillance Standards 11/2001

Bovine tuberculosis (TB) is an infectious and communicable granulomatous disease caused by the acidfast bacilli bacteria of Mycobacterium bovis (M. bovis). It is commonly a chronic, debilitating disease, but occasionally may assume an acute, rapidly progressive course. M. bovisis a widespread zoonosis that is global in magnitude and affects nearly all species of vertebrates (cattle, sheep, goats, pigs, bison, buffalo, and camelids.) Disease is spread by direct contact, inhalation of infected droplets expelled from infected lungs, and ingestion of contaminated feed or milk. In most countries, TB is a notifiable disease. Overall, TB has an important world-wide impact on animal industries and human health. Control measures are based on prevention and eradication. Surveillance is a key element for management of preventions and control programs. Surveillance for TB serves the purpose of enabling Veterinary Services to obtain an accurate picture of the scope of the disease in the US livestock populations; in the event of a disease outbreak, the course TB follows in livestock and wildlife populations for a given area over time; and permits timely intervention if the trend observed deviates from what is expected.

Plasma lipases and lipid transfer proteins increase phospholipid but not free cholesterol transfer from lipid emulsion to high density lipoproteins.

Abstract Background Plasma lipases and lipid transfer proteins are involved in the generation and speciation of high density lipoproteins. In this study we have examined the influence of plasma lipases and lipid transfer protein activities on the transfer of free cholesterol (FC) and phospholipids (PL) from lipid emulsion to human, rat and mouse lipoproteins. The effect of the lipases was verified by incubation of labeled (3H-FC,14C-PL) triglyceride rich emulsion with human plasma (control, post-heparin and post-heparin plus lipase inhibitor), rat plasma (control and post-heparin) and by the injection of the labeled lipid emulsion into control and heparinized functionally hepatectomized rats. Results In vitro, the lipase enriched plasma stimulated significantly the transfer of 14C-PL from emulsion to high density lipoprotein (p<0.001) but did not modify the transfer of 3H-FC. In hepatectomized rats, heparin stimulation of intravascular lipolysis increased the plasma removal of 14C-PL and the amount of 14C-PL found in the low density lipoprotein density fraction but not in the high density lipoprotein density fraction. The in vitro and in vivo experiments showed that free cholesterol and phospholipids were transferred from lipid emulsion to plasma lipoproteins independently from each other. The incubation of human plasma, control and control plus monoclonal antibody anti-cholesteryl ester transfer protein (CETP), with 14C-PL emulsion showed that CETP increases 14C-PL transfer to human HDL, since its partial inhibition by the anti-CETP antibody reduced significantly the 14C-PL transfer (p<0.05). However, comparing the nontransgenic (no CETP activity) with the CETP transgenic mouse plasma, no effect of CETP on the 14C-PL distribution in mice lipoproteins was observed. Conclusions It is concluded that: 1-intravascular lipases stimulate phospholipid transfer protein mediated phospholipid transfer, but not free cholesterol, from triglyceride rich particles to human high density lipoproteins and rat low density lipoproteins and high density lipoproteins; 2-free cholesterol and phospholipids are transferred from triglyceride rich particles to plasma lipoproteins by distinct mechanisms, and 3 - CETP also contributes to phospholipid transfer activity in human plasma but not in transgenic mice plasma, a species which has high levels of the specific phospholipid transfer protein activity.

Comparative Analysis of Alternative Hybrid Systems for Automotive Applications

The main objective of this work was to investigate the impact of different hybridization concepts and levels of hybridization on fuel economy of a standard road vehicle where both conventional and non-conventional hybrid architectures are treated exactly in the same way from the point of view of overall energy flow optimization. Hybrid component models were developed and presented in detail as well as the simulations results mainly for NEDC cycle. The analysis was performed on four different parallel hybrid powertrain concepts: Hybrid Electric Vehicle (HEV), High Speed Flywheel Hybrid Vehicle (HSF-HV), Hydraulic Hybrid Vehicle (HHV) and Pneumatic Hybrid Vehicle (PHV). In order to perform equitable analysis of different hybrid systems, comparison was performed also on the basis of the same usable system energy storage capacity (i.e. 625kJ for HEV, HSF and the HHV) but in the case of pneumatic hybrid systems maximal storage capacity was limited by the size of the systems in order to comply with the packaging requirements of the vehicle. The simulations were performed within the IAV Gmbh - VeLoDyn software simulator based on Matlab / Simulink software package. Advanced cycle independent control strategy (ECMS) was implemented into the hybrid supervisory control unit in order to solve power management problem for all hybrid powertrain solutions. In order to maintain State of Charge within desired boundaries during different cycles and to facilitate easy implementation and recalibration of the control strategy for very different hybrid systems, Charge Sustaining Algorithm was added into the ECMS framework. Also, a Variable Shift Pattern VSP-ECMS algorithm was proposed as an extension of ECMS capabilities so as to include gear selection into the determination of minimal (energy) cost function of the hybrid system. Further, cycle-based energetic analysis was performed in all the simulated cases, and the results have been reported in the corresponding chapters.

Energy management system: Progettazione e sviluppo di uno strumento di stima e analisi di variabili energetiche

Questo elaborato di tesi è nato con l'esigenza di sviluppare un nuovo modulo per la stima di variabili energetiche da inserire nel software On.Energy, per dare la possibilità a tutti gli utilizzatori di capire quanto i valori osservati nella realtà si discostino da un modello teorico appositamente creato, e fornire quindi un ulteriore strumento di analisi per mantenere sotto controllo il sistema nell'ottica del miglioramento continuo. Il risultato sarà uno strumento che verrà provato in via sperimentale sugli stabilimenti di due aziende leader in Italia in settori produttivi largamente differenti (Amadori - alimentare, Pfizer - farmaceutico), ma accomunati dalle esigenze di monitorare, analizzare e efficientare i consumi energetici.