Orientador: Fernando Cendes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T02:54:43Z (GMT). No. of bitstreams: 1 Goncalves_EleonoraBorges_D.pdf: 2276279 bytes, checksum: d153e20d01fc2adb69c63827fff175d1 (MD5) Previous issue date: 2013 / Resumo: Objetivos: Avaliar os transtornos depressivos em comorbidade com a epilepsia do lobo temporal (ELT), em pacientes com crises refratárias às drogas antiepilépticas (DAEs). Pacientes e métodos: Realizamos um estudo transversal, entrevistando e coletando informações dos prontuários de pacientes que procuraram atendimento no Ambulatório de epilepsia de difícil controle do HC-UNICAMP. A população foi de adultos, com idade igual ou maior de 24 anos, em acompanhamento no HC-UNICAMP, com diagnóstico de ELT refratária, em uso adequado da medicação instituída e ausência de rebaixamento intelectual, demência ou problemas de linguagem. Os pacientes foram submetidos a uma entrevista psiquiátrica semiestruturada, o que conferiu diagnóstico segundo a Classificação Internacional de Doenças (CID-10)-OMS. Aplicamos os seguintes instrumentos: (1) Mini Entrevista Neuropsiquiátrica Internacional (MINI) e (2) Inventário de Depressão de Beck (IDB). Resultados: Foram incluídos 40 pacientes com idade de 24-60 anos, trinta e um dos 40 pacientes (77,5%) apresentaram transtornos depressivos: 14 (45,2 %) com distimia, 11 (35,5%) com transtorno depressivo recorrente e 6 (19,3%) com transtorno bipolar, na ocasião depressivo. Dois (5%) apresentaram transtorno misto de ansiedade e depressão. Os outros 7 pacientes (15%) apresentaram eventuais manifestações de depressão e ansiedade, sem constituírem um diagnóstico de depressão, sendo um deles com transtorno orgânico de ansiedade. Apenas 8 dos 31 pacientes (25,8%) receberam tratamento antidepressivo satisfatório prévio. A duração da epilepsia apresentou uma tendência a ser maior nos pacientes com transtorno depressivo (p=0.10); não houve associação entre depressão e frequência de crises. Conclusões: Este trabalho confirma que o transtorno depressivo é frequente e subdiagnosticado em pacientes com ELTM refratária às DAEs. A duração da epilepsia apresenta uma tendência a ser maior nos pacientes deprimidos. Não houve associação entre depressão e frequência de crises / Abstract: Objectives: To assess depressive disorders in patients with temporal lobe epilepsy (TLE), refractory to antiepileptic drugs (AEDs). Patients and methods: We performed a cross-sectional study, interviewing and collecting information from records of patients who sought treatment at the Epilepsy Clinic of the HC-UNICAMP. The population consisted of adults aged greater than 24 years followed at UNICAMP, diagnosed with refractory TLE, in appropriate use of AEDs and lack of established mental retardation, dementia or language problems. Patients underwent a semi-structured psychiatric interview, which gave diagnosis according to the International Classification of Diseases (CID-10) - WHO. We applied the following instruments: (1) Mini International Neuropsychiatric Interview (MINI) and (2) the Beck Depression Inventory (BDI). Results: There were 40 patients aged 24-60 years. Thirty-one of these (77.5%) had depressive disorders: 14 (45.2%) with dysthymia, 11 (35.5%) with recurrent depressive disorder and 6 (19.3%) with bipolar disorder who had depression at the time of evaluation. Two (5%) had mixed anxiety disorder and depression. The other 7 patients (15%) showed signs of depression and anxiety, without imposing a diagnosis of depression, one of them with organic anxiety disorder. Only 8 of the 31 patients (25.8%) had received prior satisfactory antidepressant treatment. The duration of epilepsy tended to be higher in patients with depressive disorder (p = 0.10). There was no association between depression and seizure frequency. Conclusions: This study confirms that depressive disorder is common and underdiagnosed in patients with TLE refractory to AEDs. The duration of epilepsy had a tendency to be higher in depressed patients. There was no association between depression and seizure frequency / Doutorado / Neurologia / Doutora em Ciências Médicas

Orientador: Maria Beatriz Duarte Gavião / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-03T20:19:10Z (GMT). No. of bitstreams: 1 Castelo_PaulaMidori_M.pdf: 1360303 bytes, checksum: ff86ad02e1aded3279de6a1bd4a25c3e (MD5) Previous issue date: 2004 / Mestrado

M.A. / Himmehoch (1984, 1987) in discussion of major mood disorders related to epilepsy, describes an affective condition termed subictal mood disorder. Patients with subictal mood disorder are divided into manic-depressive and dysthymic subtypes, the former resembling an atypical, usually rapid-cycling bipolar mood disorder. The latter dysthymic group, are characterised by a baseline dysthymia, severe recurrent depressive episodes, and transient euphorias. In addition, these dysthymic patients are described as being especially prone to impulsive suicide attempts, extreme irritability, rage outbursts and deliberate self-harm. Himmelhoch (1984, 1987) postulates temporolimbic dysfunction with both ictal and subictal (subclinical) changes as the underlying aetiology. Temporolimbic phenomena such as anamnesic, dissociative and perceptive distortions are important aspects of neuropsychiatric phenomenology. Clinical evidence, however, suggests that these occurrences are not routinely sought for or uncovered during the clinical evaluation of patients and their relevance for atypical affective presentations not clearly understood. The aim of this clinical survey was to evaluate the presence and nature of both temporolimbic dysfunction and subictal mood disorder among a subpopulation of private psychiatric patients. Furthermore in order to explicate a possible association between the above, the electroencephalographic records of these patients were examined. Records of 761 patients who attended a private practice over a two-year period were retrospectively reviewed. 546 patients had been questioned in sufficient detail and were deemed reliable in their responses. Of the 546 patients reviewed 128 (23,4%) were found to have experienced significant temporolimbic phenomena. The most common features were dissociative states, deja vu, premonitions, jamais vu and tactile hallucinations. 150 (27,5%) patients met Himmelhoch's criteria for the presence of subictal mood disorder. Of those 150, 100 (66,7%) demonstrated significant temporolimbic phenomena. EEG results, with the exclusion of 16 patients (the appropriate records not being available), highlighted 64 iY (76,2%) ofthe probands as having met the criteria for significant temporolimbic phenomena and subictal mood disorder and demonstrating unequivocal abnormality onEEG. Taking into account the sample bias of this particular private practice, and the obvious flaws of a retrospective, naturalistic survey of this nature, the concept of sub ictal mood disorder is discussed. Case vignettes are used to illustrate the phenomenological presentation ofthese patients and the potential benefits of the addition of anticonvulsants in their management.

Abstract Sensory systems are considered to be optimized for their ecological niche. In vision this means highly organised regular structure and function, where nearly identical photoreceptors have graded light responses in order to be able to handle as much information as possible. Instead, cockroach compound eyes show large amounts of irregularities in their optics and structure, and unusually long axons. In this thesis photoreceptors of the cockroach were studied with intracellular recordings of their light responses, biophysical systems analysis, and modelling of the relations between the light stimuli and responses. Cockroaches prefer living in dark or extremely dim environments. However, they have large and complex compound eyes. The aim of this study was to find out the functional properties by which the visual system and especially photoreceptors have adapted to cope with, i.e. to see in, dim light conditions. The function of photoreceptors was found to vary randomly in many respects, and the long axons seemed to utilise action potential coding of visual signals. Through model simulations it was shown that signals of a group of these functionally variable and spiking photoreceptors, when pooled, could provide more reliable coding than signals of identical cells of any experimentally characterised type. This naturally sacrifices spatial resolution. The filtering dynamics of the photoreceptors is matched to low light intensities and their temporal resolution does not markedly improve with increasing light adaptation. Adaptation processes in the photoreceptors saturated near an intensity of about 1000 effective photons/s. These are all both unexpected and novel features of photoreceptor function. Spatial summation of functionally different photoreceptors and reduced temporal resolution and contrast coding abilities can be considered to be permanent optimizations to a dim environment.

Tesis presentada a la Universidad de Chile para optar al grado de Doctora en Ciencias Farmacéuticas / La epilepsia del lóbulo temporal (ELT) se desarrolla de manera progresiva durante la epileptogénesis, después de la cual se producen crisis epilépticas espontáneas. Para su estudio, se necesitan modelos animales bien caracterizados de este proceso, que permitan aclarar los mecanismos moleculares subyacentes, entre los cuales se encuentra el rol del óxido nítrico (NO), al cual la literatura ha dado roles controversiales. En esta tesis, se utilizó como modelo experimental el kindling farmacológico con pentiléntetrazol (PTZ), que consiste en la administración de 10 dosis subconvulsivantes de PTZ, día por medio. Este modelo fue caracterizado conductual y electroencefalográficamente. Posteriormente, se realizaron experimentos con moduladores de los niveles corticales de NO. Se analizaron conductualmente 3 dosis de PTZ (20, 30 y 40 mg/Kg) durante los días de inyección. El grado de crisis máximo alcanzado mostró que la intensidad de las crisis aumenta conforme aumenta la dosis de PTZ administrada. Además, se observó que a dosis bajas (20 mg/Kg) el aumento de la intensidad de las crisis evoluciona lentamente y no llega a grados 5 y 6 durante los 20 días que dura el kindling, lo que la hizo elegible para la caracterización electroencefalográfica de este modelo. Se analizaron registros de electroencefalograma (EEG), tanto durante los días en que se inyectó PTZ (20 mg/kg) como en los días de no inyección (intermedios a éstas) y, a continuación, 25 días después de la última dosis de PTZ, cuantificando el número, la duración y el perfil espectral de las descargas epilépticas. Los niveles de óxido nítrico fueron modulados localmente en la corteza cerebral. El número de descargas epileptiformes aumentó durante el kindling, así como 25 días después de su finalización, lo que revela la inducción de un proceso epileptogénico auto-sostenible. Las descargas epilépticas se caracterizaron por un aumento en las frecuencias de la banda theta (4-8 Hz), las que se asocian con crisis de tipo ausencia. Sin embargo, durante kindling, cuando la intensidad de las crisis epilépticas aumenta, la potencia espectral de la banda theta disminuyó progresivamente; mientras que, el poder de frecuencias más altas (banda beta bajo) aumentó. El NO en la corteza cerebral inhibió el número y la amplitud de las descargas epilépticas. La caracterización electroencefalográfica de del kindling con PTZ proporciona un valioso modelo para detectar con precisión las consecuencias de las intervenciones terapéuticas en epileptogénesis, especialmente las dirigidas a detener este proceso. La producción local de óxido nítrico en la corteza cerebral podría ser útil para contrarrestar los efectos deletéreos y la propagación de las descargas epilépticas / Temporal lobe epilepsy (TLE) is developed in a progressive manner during epileptogenesis, after which spontaneous seizures occur. To study epileptogenesis, well-characterized animal models of this process are necessary to clarity underlying molecular mechanisms, among which nitric oxide (NO) has a controversial role throughout the literature. In this thesis, a pharmacological kindling model was used by means of administration of 10 subconvulsive doses of pentylenetetrazole (PTZ), every other day. The characterization of this epileptogenesis model was monitored by behavioral and electroencephalographic recordings. Subsequently, NO levels in the cerebral cortex were modulated. PTZ kindling was performed with three doses (20, 30 and 40 mg/Kg) to analyze behaviors during injection days. The maximum degree of seizure recorded each day shows that seizures intensity rises along the days of the protocol. In addition, at low PTZ doses (20 mg/kg), the seizure intensity increased slowly through the protocol, without reaching grades 5 or 6 during the 20 days of the kindling processmaking it a suitable dose for the electroencephalographic characterization of this model. Electroencephalogram recordings (EEG) were analyzed, both during injection and inter-injection days. In addition, EEG recordings were performed 25 days after the last PTZ dose. The number, duration and spectral profile of epileptic discharges. Nitric oxide levels were modulated locally in the cerebral cortex. The number of epileptiform discharges increased during the kindling protocol, and 25 days after its completion, revealing the induction of a self-sustaining epileptogenic process. Epileptic discharges were characterized by an increase in theta band frequency (4-8 Hz) associated with absence-like seizure. However, during the kindling protocol, when the intensity of seizures increases, the spectral power of the theta band decreases progressively, while the power of higher frequencies (low beta band) is increased. NO in cerebral cortex inhibited the number and amplitude of epileptic discharges. The electroencephalographic characterization of this PTZ kindling protocol provides a valuable model to detect precisely consequences of therapeutic interventions on epileptogenesis, especially those targeted towards stopping this process. Local production of nitric oxide in the cerebral cortex could be useful to counteract the deleterious effects and the propagation of epileptic discharges

Abstract This study was undertaken to improve the diagnosis of otitis media and to investigate possible hearing loss caused by middle ear effusion (MEE) in small children. The accuracy of minitympanometry in detecting MEE was evaluated in 162 children. The finding was compared with the amount of effusion found in myringotomy. Minitympanometry proved to be an accurate method to detect MEE in young children, the sensitivity and specificity values being 79% and 93% in cooperative children but it had no value in non-cooperative children. Minitympanometric examination could be performed successfully with good cooperation in 87% of a total of 206 children in paediatric outpatient clinic. Impaired mobility of the tympanic membrane (TM) was the best sign of MEE in pneumatic otoscopy of 76 children, with sensitivity and specificity values of 75% and 90%, respectively. The influence of nitrous oxide (N2O) on MEE was tested by weighting the effusion found in myringotomy during general anaesthesia with and without N2O in 39 and 37 children, respectively. The mean weight of the effusion in the oxygen-air group did not differ from the weight in the N2O group, and thus peroperative findings in myringotomy are reliable. Studies on symptomatology and the temporal development of acute otitis media (AOM) during upper respiratory tract infection (URI) were based on three-month follow-up of 857 children. Symptoms of URI only were compared with symptoms of URI complicated by AOM in the same child in 138 children. The most important symptom associated with AOM was earache, with a relative risk of 21.3. Sore throat, night restlessness and fever at days 3-6 were also significantly associated with AOM, with relative risks of 3.2, 2.6 and 1.8, respectively. In 44 children under two years of age, earache, conjunctival symptoms and cloudy rhinitis were significantly associated with AOM. Temporal development of AOM was assessed from 250 episodes in 184 children. Sixty-three per cent of cases of AOM occurred during the first week after the onset of URI, peaking on days 2 to 5. The onset of AOM in children with a history of recurrent episodes of AOM did not differ from that in those who had experienced only a few episodes of AOM. No individual tendency was noticed among children suffering more than one AOM episode during follow-up. To assess the influence of the quantity and quality of MEE on hearing in small children, transient evoked otoacoustic emission (TEOAE) was performed under general anaesthesia before myringotomy in 185 ears of 102 children. Reduced TEOAEs indicating hearing loss were found in 83% of the ears with mucoid effusion and in 56% of the ears with non-mucoid effusion, the difference being statistically significant (p < 0.01). A significant negative correlation between the reproducibility of TEOAE responses and the amount of effusion was found (Spearman rank correlation coefficient r = -0.589, p < 0.001). Findings in minitympanometry correlated with the responses of TEOAE. Although parents are able to predict AOM quite reliably, various symptoms and the duration of URI seems to be of little value in helping the diagnosis of AOM. Detection of effusion in OM may be improven by minitympanometry in cooperative children. Any kind of effusion may cause hearing loss in small children, which must be considered when treating OM.

Jessica Bell’s MFA thesis exhibition, All things being equal., presents the very idea of constructing a painting as a way of making sense of the world. Simple materials and formal devices make allusions to ordinary events and experiences. The works bear the marks of incidental studio occurrences, which conjure a conversation between the will of objects and the artist’s intention to activate them. Canvas and stretchers appear like characters, assuming the posture of active participants instead of subservient structure. The pieces engage with and resonate in one another, emphasizing the temporal relationship with the physical space. The forms are deliberately abstract and minimal, drawing our attention to subtle differences in the surfaces of material, gentle play with volume and light, and the quiet passage of time. All things being equal. was exhibited at the Ottawa Art Gallery’s Firestone Gallery in Ottawa from August 21 through September 13, 2015.

Schizophrenia (SCZ) is a complex psychiatric disorder including various symptoms. Resting-state fMRI investigations mostly focused on functional connectivity alterations in SCZ reflecting the spontaneous activity’s spatial structure. Complementing its spatial structure, the brain’s spontaneous activity can be characterized by a complex temporal structure such as scale-free dynamics or long- range temporal correlations (LRTCs). However, it remains an open question whether the temporal structure of spontaneous brain activity, as indexed by the power-law exponent (PLE), can provide biomarkers specific to SCZ as distinguished from other psychiatric disorders like major depressive disorder (MDD) and bipolar disorder (BP). Here, we studied a large-scale cohort (n = 244) of two independent schizophrenic data sets (n = 45), MDD (n = 28), and BP patients (n = 73, in manic, depressed, and euthymic phases) and 98 healthy controls. We found significant PLE reduction in specifically the medial prefrontal cortex (mPFC) in SCZ. This was replicated in an independent sample and was shown to be specific when compared to MDD and different phases of BP. Due to its disease-specific nature, the mPFC PLE reduction may eventually serve as a biomarker for SCZ.

Since the initialization of economic reforms in 1978, China has undergone significant urbanization and modernization at an increasingly rapid pace, with the national urbanization rate increasing from 17.9% in 1978 to 57.4% in 2016. An increasingly significant portion of China’s population is integrating itself into thriving urbanized areas. Though amounting to only 8.5% of the nation’s total population (1.5 billion), China’s ethnic minority population remains considerable in number. In the future, by adopting the National New-Type Urbanization Plan in 2014, China’s urbanization is expected to evolve into a more human-oriented process, as the plan ambitiously aims to increase the urban population by another 200 million, most of which will consist of Chinese ethnic minorities. It is hoped that this increase will boost the urbanization rate among Chinese ethnic minorities. The gaps within existing literature and the practicality of improving the inclusivity of the urban minority population in the urbanization process legitimize the development of a comprehensive and retrospective study of the evolution of spatial-temporal dynamics of the distribution of Chinese ethnic groups with a Chinese urbanization perspective on a national scale. Based on national census data from 1990, 2000, and 2010, this study adopts the Standard Deviational Ellipse as a distributional trend measurement of minorities in urban China and determines four major new features of the distribution of the Chinese ethnic minorities over the last twenty-years in China’s urbanization context. First, a three-stage peripheral-to-core transition pattern was observed. Second, it is observed that there is an escalating decline of the urban minority population in the central region of China, particularly since 2000. Third, national-level city agglomerations located in the eastern region of China have begun to play leading roles in minority urbanization, particularly those located in the Yangtze and Pearl River Delta. Fourth, in both China’s west region and its autonomous areas, as continuous beneficiaries of supportive policies, metropolises, such as provincial capitals, have been shaped into important regional minority population concentrations. This study also allows for a better insight of Chinese urbanization processes and their inter/intra-relating mechanisms in ethnic minority areas. Finally, this study’s findings provide insightful and detailed information for scholars, policy and, ultimately, decisionmakers, to improve the process for sustainable and inclusive urbanization in China.

Highly dynamic and complex computing systems are increasingly needed and are relied upon in daily life. One such system is the dynamic network, particularly in communication, in which it has widespread applications, such as: Internet, peer-to-peer networks, mobile networks and wireless networks. Dynamic networks consist of nodes and edges whose operating status may change over time; the edges may be unreliable and operate intermittently. Message-passing in such networks is inherently difficult and reasoning about the behaviour of message-passing algorithms is also difficult and hard to analyse. Their behaviour and correctness are hard to formulate and establish. To undertake formal reasoning about such systems, abstract models are essential in order to separate the general reasoning about message routing and the updating of routing tables from the details of how these are implemented in particular networks. This thesis proposes a new approach to modelling and reasoning about dynamic networks as follows. It develops a series of abstract models which makes it possible to focus on the correctness of routing methods. It models the dynamic network as a “demonic” process which runs concurrently with routing updates and message-passing, to express dynamic networks as concurrent systems. This allows the use of temporal logic and fairness constraints to reason about dynamic networks. To do so, it introduces a modal logic and formulates concepts of fairness which capture network properties. The correctness of dynamic networks means that under certain conditions, all messages will eventually be delivered. Formulating networks as concurrent systems means can establish the correctness for networks that never cease to change. Modelling at that one level of abstraction means being able to prove the properties of networks independently of the mechanisms in actual networks. Therefore, it provides “a factorisation” of proofs of correctness for actual dynamic networks. The models are implemented as multi-threaded programs, and then adopted an experimental runtime verification tool called RULER to test whether model instances satisfy the modal correctness for message delivery.