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Benign focal seizures of adolescence and neuropsychological findings in patients from community

RATIONALE: Benign focal seizures of adolescence (BFSA) described by Loiseau et al in 1972, is considered a rare entity, but maybe underdiagnosed. Although mild neuropsychological deficits have been reported in patients with benign epilepsies of childhood, these evaluations have not so far been described in BFSA. The aim of this study is to evaluate neuropsychological functions in BFSA with new onset seizures (<12 months). METHODS: Eight patients with BFSA (according to Loiseau et al, 1972, focal or secondarily tonic clonic generalized seizures between the ages of 10-18 yrs., normal neurologic examination, normal EEG or with mild focal abnormalities) initiated in the last 12 months were studied between July 2008 to May 2009. They were referred from the Pediatric Emergency Section of the Hospital Universitário of the University of Sao Paulo, a secondary care regionalized facility located in a district of middle-low income in Sao Paulo city, Brazil. The study was approved by the Ethics Committee of the Institution. All patients performed neurological, EEG, brain CT and neuropsychological evaluation which consisted of Raven's Special Progressive Matrices - General and Special Scale (according to different ages), Wechsler Children Intelligence Scale-WISC III with ACID Profile, Trail Making Test A/B, Stroop Test, Bender Visuo-Motor Test, Rey Complex Figure, Rey Auditory Verbal Learning Test-RAVLT, Boston Naming Test, Fluency Verbal for phonological and also conceptual patterns - FAS/Animals and Hooper Visual Organization Test. For academic achievement, we used a Brazilian test for named "Teste do Desempenho Escolar", which evaluates abilities to read, write and calculate according to school grade. RESULTS: There were 2 boys and 6 girls, with ages ranging from 10 yrs. 9 m to 14 yrs. 3 m. Most (7/8) of the patients presented one to two seizures and only three of them received antiepileptic drugs (AEDs). Six had mild EEG focal abnormalities and all had normal brain CT. All were literate, attended regular public schools and scored in a median range for IQ, and seven showed discrete higher scores for the verbal subtests. There were low scores for attention in different modalities in six patients, mainly in alternated attention as well as inhibitory subtests (Stroop test and Trail Making Test part B). Four of the latter cases who showed impairment both in alternated and inhibitory attention were not taking AEDs. Visual memory was impaired in five patients (Rey Complex Figure). Executive functions analysis showed deficits in working memory in five, mostly observed in Digits Indirect Order and Arithmetic tests (WISC III). Reading and writing skills were below the expected average for school grade in six patients according to the achievement scholar performance test utilized. One patient of this series who had the best scores in all tests was taking phenobarbital. CONCLUSIONS: Neuropsychological imbalance between normal IQ and mild dysfunctions such as in attention domain and in some executive abilities like working memory and planning, as well as difficulties in visual memory and in reading and writing, were described in this group of patients with BFSA from community. This may reflect mild higher level neurological dysfunctions in adolescence idiopathic focal seizures probably caused by an underlying dysmaturative epileptogenic process. Although academic problems often have multiple causes, a specific educational approach may be necessary in these adolescents, in order to improve their scholastic achievements, helping in this way, to decrease the stigma associated to epileptic seizures in the community.

On state representations of nonlinear implicit systems

This work considers a semi-implicit system A, that is, a pair (S, y), where S is an explicit system described by a state representation (x)over dot(t) = f(t, x(t), u(t)), where x(t) is an element of R(n) and u(t) is an element of R(m), which is subject to a set of algebraic constraints y(t) = h(t, x(t), u(t)) = 0, where y(t) is an element of R(l). An input candidate is a set of functions v = (v(1),.... v(s)), which may depend on time t, on x, and on u and its derivatives up to a Finite order. The problem of finding a (local) proper state representation (z)over dot = g(t, z, v) with input v for the implicit system Delta is studied in this article. The main result shows necessary and sufficient conditions for the solution of this problem, under mild assumptions on the class of admissible state representations of Delta. These solvability conditions rely on an integrability test that is computed from the explicit system S. The approach of this article is the infinite-dimensional differential geometric setting of Fliess, Levine, Martin, and Rouchon (1999) (`A Lie-Backlund Approach to Equivalence and Flatness of Nonlinear Systems`, IEEE Transactions on Automatic Control, 44(5), (922-937)).

A four-stage index 2 Diagonally Implicit Runge-Kutta method

High index Differential Algebraic Equations (DAEs) force standard numerical methods to lower order. Implicit Runge-Kutta methods such as RADAU5 handle high index problems but their fully implicit structure creates significant overhead costs for large problems. Singly Diagonally Implicit Runge-Kutta (SDIRK) methods offer lower costs for integration. This paper derives a four-stage, index 2 Explicit Singly Diagonally Implicit Runge-Kutta (ESDIRK) method. By introducing an explicit first stage, the method achieves second order stage calculations. After deriving and solving appropriate order conditions., numerical examples are used to test the proposed method using fixed and variable step size implementations. (C) 2001 IMACS. Published by Elsevier Science B.V. All rights reserved.

A Petri Nets-based Scheduling Methodology forMultipurpose Batch Plants.

This article presents an optimization methodology of batch production processes assembled by shared resources which rely on a mapping of state-events into time-events allowing in this way the straightforward use of a well consolidated scheduling policies developed for manufacturing systems. A technique to generate the timed Petri net representation from a continuous dynamic representation (Differential-Algebraic Equations systems (DAEs)) of the production system is presented together with the main characteristics of a Petri nets-based tool implemented for optimization purposes. This paper describes also how the implemented tool generates the coverability tree and how it can be pruned by a general purpose heuristic. An example of a distillation process with two shared batch resources is used to illustrate the optimization methodology proposed.

Optimal control of nonlinear differential algebraic equation systems

A novel iterative procedure is described for solving nonlinear optimal control problems subject to differential algebraic equations. The procedure iterates on an integrated modified linear quadratic model based problem with parameter updating in such a manner that the correct solution of the original non-linear problem is achieved. The resulting algorithm has a particular advantage in that the solution is achieved without the need to solve the differential algebraic equations . Convergence aspects are discussed and a simulation example is described which illustrates the performance of the technique. 1. Introduction When modelling industrial processes often the resulting equations consist of coupled differential and algebraic equations (DAEs). In many situations these equations are nonlinear and cannot readily be directly reduced to ordinary differential equations.

A saúde ambiental e os resíduos de serviços de saúde nos três níveis de complexidade do Sistema Único de Saúde - SUS

The environmental management in the health establishments is a reality still little explored in the health sector in Brazil, especially concerning its wastes. The management of wastes of health services is established in the valid legislation through the National Council of Environment and Sanitary Vigilance Agency (358/2005 and 304/2004 respectively). The present work is about a descriptive work about the environmental health in the health services. The used criterion was to diagnose the environmental management in twelve establishments of health inserted in the three levels of complexity of the Unique Health System (Sistema Ùnico de Saúde SUS). Among the sub criteria used the waste management is the one of bigger concern. The one referring to the water quality is considered good. The analysis of data reveals that 66% of the establishments got a poor environmental ranking, 17% critical and 17% appropriate, showing that the health establishments in the three levels of complexity of the SUS need urgent structural, environmental and educational interventions

La migración internacional desde una perspectiva regional e interregional: principales conclusiones, mensajes y recomendaciones del proyecto de la Cuenta para el Desarrollo de las Naciones Unidas (sexto tramo) sobre "Fortalecimiento de las capacidades nacionales para la gestión de la migración internacional: maximizando los beneficios para el desarrollo y minimizando los impactos negativos"

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Modelos macroeconométricos de la banca central: Centroamérica y República Dominicana

Este libro fue elaborado por la Comisión Económica para América Latina y el Caribe (CEPAL) bajo la coordinación de Luis Miguel Galindo Paliza y Juan Carlos Moreno-Brid. Forma parte del proyecto “Fortaleciendo las capacidades para el análisis de políticas macroeconómicas en Centroamérica y República Dominicana” [Development Account 04/05 S (ROA/62)], originado y financiado por el Departamento de Asuntos Económicos y Sociales (DAES) de la Organización de las Naciones Unidas, en colaboración con la CEPAL, la Secretaría Ejecutiva del Consejo Monetario Centroamericano (SECMCA) y los bancos centrales de Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua y República Dominicana.

El mandato por el Agua y su aplicación a una organización colombiana

Actualmente las organizaciones en su búsqueda por ser ecoeficientes y generar una mejor practica en sus procesos productivos, ha buscado generar herramientas y mediciones que le permitan llevar a cabo una producción más limpia. Es por ello que en su afán han buscado una manera óptima de abordar un tema de preocupación mundial; el manejo del agua. Esta investigación tiene como eje central aterrizar al idioma español, el mandato por el agua un documento dado a conocer por el pacto global, el cual contiene herramientas, métricas y guías sobre el manejo del agua en las organizaciones. Adicional a esto la presente investigación pretende ver su pertinencia al contexto colombiano mediante la aplicación en a una organización.