A systematic review and meta-analysis of lithium augmentation of tricyclic and second generation antidepressants in major depression.

BACKGROUND: Lithium augmentation of antidepressants for treatment of unipolar major depression was one of the first adjunctive strategies based on a neuropharmacologic rationale. Randomized controlled trials supported its efficacy but most trials added lithium to tricyclic antidepressants (TCAs). Despite its efficacy, use of lithium augmentation remains infrequent. The current systematic review and meta-analysis examines the efficacy of lithium augmentation as an adjunct to second generation antidepressants as well as to TCAs and considers reasons for its infrequent use. METHOD: A systematic search of Medline and the Cochrane Clinical Trials database was performed. Randomized, placebo-controlled trials of lithium augmentation were selected. A fixed-effects meta-analysis was performed. Odds ratios for response were calculated for each treatment-control contrast, for the trials grouped by type of initial antidepressant (TCA or second generation antidepressant), and as a meta-analytic summary for all treatments combined. RESULTS: Nine trials that included 237 patients were selected. The odds ratio for response to lithium vs. placebo in all contrasts combined was 2.89 (95% CI 1.65, 5.05, z=3.72, p=0.0002). Heterogeneity was very low, I(2)=0%. Adjunctive lithium was effective with TCAs (7 contrasts) and with second generation agents (3 contrasts). Discontinuation due to adverse events was infrequent and did not differ between lithium and placebo. LIMITATIONS: The meta-analysis is limited by the small size and number of trials and limited data for treatment resistant patients. CONCLUSIONS: Adjunctive lithium appears to be as effective for second generation antidepressants as it was for the tricyclics.

Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial.

BACKGROUND: Treatment strategies for mental disorders may vary according to illness stage. However no data currently exist to guide treatment in first episode psychotic mania. The aim of this study was to compare the safety and efficacy profile of chlorpromazine and olanzapine, as add-on to lithium, in patients with a first episode of psychotic mania, expecting better safety profile and adherence to olanzapine but similar efficacy for both treatments. METHODS: Data from 83 patients were collected in an 8-week randomised controlled trial on clinical variables, side effects, vital signs, and weight. Analyses of treatment differences over time were based on intent-to-treat principles. Kaplan-Meier estimated survival curves were used to analyse time-to-event data and mixed effects models repeated measures analysis of variance were used to determine treatment group differences over time on safety and efficacy measures. RESULTS: Ethics committee approval to delay informed consent procedure until recovery from the acute episode allowed the inclusion of 83 patients highly representative of those treated in the public sector. Contrary to our hypotheses, safety profile of both medications was similar. A signal for higher rate (P=.032) and earlier occurrence (P=.043) of mania remission was observed in the olanzapine group which did not survive correction for multiple comparisons. CONCLUSIONS: Olanzapine and chlorpromazine have a similar safety profile in a uniquely representative cohort of patients with first episode psychotic mania. The possibility for a greater impact of olanzapine on manic symptoms leading to earlier remission of the episode needs exploration in a large sample.

Lithium nephropathy: a case report

Although widely used in the management of bipolar disorder, lithium may cause adverse kidney effects. The importance of the present study is to report the case of a 59-year-old woman who was under regular treatment with lithium for bipolar disorder and whose imaging studies demonstrated the presence of multiple renal microcysts, suggesting lithium nephropathy as main diagnostic hypothesis.

Adaptive optimization schemes for mobile VoIP applications Battery life and call quality aspects

In this thesis programmatic, application-layer means for better energy-efficiency in the VoIP application domain are studied. The work presented concentrates on optimizations which are suitable for VoIP-implementations utilizing SIP and IEEE 802.11 technologies. Energy-saving optimizations can have an impact on perceived call quality, and thus energy-saving means are studied together with those factors affecting perceived call quality. In this thesis a general view on a topic is given. Based on theory, adaptive optimization schemes for dynamic controlling of application's operation are proposed. A runtime quality model, capable of being integrated into optimization schemes, is developed for VoIP call quality estimation. Based on proposed optimization schemes, some power consumption measurements are done to find out achievable advantages. Measurement results show that a reduction in power consumption is possible to achieve with the help of adaptive optimization schemes.

Materiais para cátodos de baterias secundárias de lítio

In this work, cathodes employed in secondary lithium batteries are reviewed. These cathodes have great technologic and scientific importance, specifically, materials for cathodes as electronic conductor polymers (ECP), transition metal oxides (TMO) and nanocomposites of ECP/TMO. The use of a specific cathodic material is based in some intrinsic characteristics that improve the performance of the battery. Thus, some vantages and disvantages of these insertion compounds are discussed, as lithium insertion capacity, energy density, and the ciclability of these materials.

Recuperação de cobalto e de lítio de baterias íon-lítio usadas

The "active mass" (cathode + anode + electrolyte) of spent Li-ion batteries was submitted to one of the following procedures: (a) it was calcined (500 ºC) and submitted to extraction with water to recover lithium salts. The residual solid was treated with sulfuric acid containing hydrogen peroxide. Cobalt was recovered as sulfate; (b) the "active mass" was treated with potassium hydrogen sulfate (500 ºC) and dissolved in water. Cobalt was precipitated together with copper after addition of sodium hydroxide. Lithium was partially recovered as lithium fluoride. Co-processing of other battery components (aluminum and copper foils) affected negatively the behavior of the recovery procedures. Previous segregation of battery components is essential for an efficient and economical processing of the "active mass".

Poly(o-methoxyaniline) modified electrode for detection of lithium ions

This paper reports the use of an electrode modified with poly(o-methoxyaniline) for detecting lithium ions. These ions are present in drugs used for treating bipolar disorder and that requires periodical monitoring of the concentration of lithium in blood serum. Poly(o-methoxyaniline) was obtained electrochemically by cyclic voltammetry on the surface of a gold electrode. The results showed that the electrode modified with a conducting polymer responded to lithium ions in the concentration range of 1 x 10-5 to 1 x 10-4 mol L-1 . The results also confirmed that the performance of the modified electrode was comparable to that of the standard method (atomic emission spectrophotometry).

Akkujen ja superkondensaattorien yhteiskäyttö energiavarastoina ja niiden verkkoon liittäminen ajoneuvoissa

Ajoneuvojen tiukentuneet päästörajoitukset, sekä ajoneuvojen kokonaishyötysuhteen parantamisen tarve ohjaavat ajoneuvovalmistajia kehittämään uusia ratkaisuja. Energiavarastojen käyttö ajoneuvoissa on yleistynyt ja niiden käytöllä voidaan saada huomattava energiasäästö. Tässä kandidaatintyössä on esitelty erilaisia energiavarastoja ja niiden verkkoon liittämistä. Pääpaino työssä on akkujen ja superkondensaattorien rinnankytkennässä. Energiavarastot pyritään kytkemään mahdollisimman vähällä tehoelektroniikalla verkkoon. Esimerkkitapaukseksi on otettu litium-ioni akkujen ja superkondensaattorien rinnankytkentä vaihtojännitteeseen pelkällä invertterillä.

Energy storage in electric drive system

In recent years the environmental issues and the energy saving have become increasingly import in modern society where industry is the major emission factor and energy consumer. Generally, most of the total energy consumption is caused by electrical drives used in industrial applications and thus improving the performance of electrical drives give an opportunity to improve the energy efficiency. In this Master Thesis improving the energy efficiency in different electrical drives is clarified with different cases: regenerative braking in the electric grid or recovery of the braking energy into an energy storage. In addition, as an example, the energy consumption of an elevator is analyzed by measurements. From these measurement results it can be estimated how much the share of the standby energy consumption is from the total energy consumption and how much regenerative energy is available. The latter part of the thesis concentrates on determination of the properties of lithium iron phosphate battery with measurements.

Litium-ioniakun tasapainon hallinta

Nykyaikaisen liikkuvan sähkökäytön energianlähteenä voi toimia jopa sadoista yksittäisistä sarjaankytketyistä litium-ionikennoista muodostuva akusto. Luotettaviin mittauksiin perustuva valvonta ja käytönohjaus on erityisen tärkeää litium-ioniakuissa, jotka ovat herkkiä yli- ja alijännitteille sekä korkeille lämpötiloille. Monipuolinen hallintajärjestelmä auttaa hyödyntämään akun koko kapasiteetin sekä säilyttämään akun suorituskyvyn estämällä väärinkäytön. Tässä työssä keskitytään tarkastelemaan monikennoisten litium-ioniakkujen sovelluksissa ilmeneviä haasteita sekä eri julkaisuissa esitettyjä ratkaisumalleja akun tasapainon hallitsemiseksi.

Litium-polymeeri- ja litium-rautafosfaattiakkujen käyttö kannettavassa audiolaitteessa

Akkuteknologia on kehittynyt viime vuosina erityyppisten litium-ioniakkujen hallitessa markkinoita. Uutta teknologiaa kaupallisissa litium-pohjaisissa akuissa edustavat litium-polymeeri- ja litium-rautafosfaattiakut. Työn tarkoituksena oli selvittää soveltuvatko litium-polymeeri- ja litium-rautafosfaattiakut kannettavaan audiolaitteeseen ja verrata näitä Ni-Cd- ja Ni-Mh-akkuihin sekä LiCoO2- ja LiMnO4-kemian litium-ioniakkuihin. Kyseisten akkutyyppien soveltuvuutta kannettavaan audiolaitteeseen ei kirjallisuudessa ole juuri tutkittu. Työ toteutettiin kirjallisuustutkimuksena.

Effect of metabolic acidosis on renal tubular sodium handling in rats as determined by lithium clearance

Systemic metabolic acidosis is known to cause a decrease in salt and water reabsorption by the kidney. We have used renal lithium clearance to investigate the effect of chronic, NH4Cl-induced metabolic acidosis on the renal handling of Na+ in male Wistar-Hannover rats (200-250 g). Chronic acidosis (pH 7.16 ± 0.13) caused a sustained increase in renal fractional Na+ excretion (267.9 ± 36.4%), accompanied by an increase in fractional proximal (113.3 ± 3.6%) and post-proximal (179.7 ± 20.2%) Na+ and urinary K+ (163.4 ± 5.6%) excretion when compared to control and pair-fed rats. These differences occurred in spite of an unchanged creatinine clearance and Na+ filtered load. A lower final body weight was observed in the acidotic (232 ± 4.6 g) and pair-fed (225 ± 3.6 g) rats compared to the controls (258 ± 3.7 g). In contrast, there was a significant increase in the kidney weights of acidotic rats (1.73 ± 0.05 g) compared to the other experimental groups (control, 1.46 ± 0.05 g; pair-fed, 1.4 ± 0.05 g). We suggest that altered renal Na+ and K+ handling in acidotic rats may result from a reciprocal relationship between the level of metabolism in renal tubules and ion transport.

Keskitehoestimaattorin lisääminen diesel-sähköiseen hybridijärjestelmään

Nykyajan jatkuvasti kiristyvät päästörajoitukset ja ilmastonmuutoksen uhka ovat ajavia voimia kehittämään voimalaitosten tekniikkaa energiatehokkaampaan ja ympäristöystävällisempään suuntaan. Polttomoottoritekniikan parantaminen on tärkeä osa tätä kehitystä, mutta jo nykyisiä moottoreita voitaisiin ajaa energiate-hokkaammin käyttämällä akustoa ja älykästä säätöjärjestelmää apuna. Työssä tutkitaan simulaatioiden avulla voidaanko ulkomerellä toimivan huolto-aluksen energiatehokkuutta parantaa muokkaamalla sen tehon tuottoa keskitehoes-timaattorin ja akuston avulla.