RESUMEN
Snake robots, also known as apodal robots, are among the most common and versatile modular robots. Primarily due to their ability to move in different patterns, they can evolve in scenarios with several constraints, some of them hardly accessible to other robot configurations. This paper deals with a specific environment constraint where the robot needs to climb a prismatic obstacle, similar to a step. The objective is to carry out simulations of this function, before implementing it in the physical model. To this end, we propose two different algorithms, parameterized by the obstacle dimensions determined by image processing, and both are evaluated in simulated experiments. The results show that both algorithms are viable for testing in real robots, although more complex scenarios still need to be further studied.
RESUMEN
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), affects millions of people worldwide. Polymerase Chain Reaction (PCR) and real-time quantitative PCR (qPCR) have been used as tools to monitor parasitic levels in the bloodstream of individuals exposed to infection, thus enabling the monitoring of relapses and the effectiveness of therapy, for example. The aim of this study was to evaluate the TcSAT-IAM system, developed by our research group, on samples from patients with suspected Chagas disease infection. Initially, primer systems were developed for the detection of the nuclear DNA (SAT-DNA) from T. cruzi (TcSAT-IAM). The Cruzi system, predicted in the literature, and TcSAT-IAM were then evaluated in relation to their analytical sensitivity, specificity and efficiency. Afterwards, the applicability of the qPCR technique using both systems (separately) for the diagnosis of acute CD was evaluated in samples from 77 individuals exposed to the outbreak that occurred in Pernambuco-Brazil, relating the results obtained to those of the classical diagnostic methods recommended for this stage of the infection. TcSAT-IAM and Cruzi had a detection limit of 1 fg of target DNA (0,003 parasites). Thirty-eight cases were recorded, 28 by laboratory criteria and 10 by clinical and epidemiological criteria. Blood samples from 77 subjects were submitted to qPCR by both systems, reaching an agreement of 89.61% between them. After analyzes between systems and diagnostic criteria, the TcSAT-IAM showed sensitivity and specificity of 52.36% (CI 37.26-67.52) and 92.31% (CI 79.68-97.35), respectively, accuracy of 72.73% and moderate agreement. The TcSAT-IAM showed an accuracy of 72.58% and 75% in relation to parasitological and serological tests (IgM anti-T. cruzi), respectively. Therefore, quantitative PCR should be incorporated into the diagnosis of suspected acute cases of Chagas disease.
Asunto(s)
Enfermedad de Chagas , Trypanosoma cruzi , Humanos , Brasil/epidemiología , Patología Molecular , ADN Protozoario/genética , Enfermedad de Chagas/diagnóstico , Enfermedad de Chagas/epidemiología , Enfermedad de Chagas/tratamiento farmacológico , Trypanosoma cruzi/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Brotes de EnfermedadesRESUMEN
A 62-year-old man presented with a history of fever, headache, anosmia, ageusia, and diarrhea for 9 days. A clinical and epidemiological diagnosis of infection with the novel coronavirus was made. After symptom refractoriness, the second step involves using human intravenous immunoglobulin. Early diagnosis of macrophage activation syndrome (MAS) involves observation of the refractory nature of clinical support treatment associated with biochemical changes to the patient's baseline characteristics, suggesting the relevance of a favorable clinical outcome of weaning from artificial life support when there is an early suspicion of a diagnosis of MAS secondary to coronavirus disease 2019 infection.
Asunto(s)
COVID-19 , Síndrome de Activación Macrofágica , Diagnóstico Precoz , Fiebre , Humanos , Síndrome de Activación Macrofágica/complicaciones , Síndrome de Activación Macrofágica/diagnóstico , Síndrome de Activación Macrofágica/tratamiento farmacológico , Masculino , Persona de Mediana Edad , SARS-CoV-2RESUMEN
ABSTRACT A 62-year-old man presented with a history of fever, headache, anosmia, ageusia, and diarrhea for 9 days. A clinical and epidemiological diagnosis of infection with the novel coronavirus was made. After symptom refractoriness, the second step involves using human intravenous immunoglobulin. Early diagnosis of macrophage activation syndrome (MAS) involves observation of the refractory nature of clinical support treatment associated with biochemical changes to the patient's baseline characteristics, suggesting the relevance of a favorable clinical outcome of weaning from artificial life support when there is an early suspicion of a diagnosis of MAS secondary to coronavirus disease 2019 infection.
Asunto(s)
Fusariosis , Fusarium , Antifúngicos/uso terapéutico , Agricultores , Fusariosis/tratamiento farmacológico , Humanos , PielRESUMEN
Introdução: Sepse é uma síndrome de resposta inflamatória sistêmica associada a foco infeccioso e às disfunções orgânicas. Sabe-se que, no processo infeccioso, a resposta do hospedeiro consiste no aumento do número de neutrófilos e na redução do número total de linfócitos. O índice neutrófilo/linfócito (N/L) é uma ferramenta facilmente calculável a partir do hemograma, e tem sido utilizada como indicador prognóstico em diversas condições patológicas. Esta pesquisa visa avaliar o valor prognóstico das médias da relação neutrófilo-linfócito em pacientes sépticos em unidades de terapia intensiva de Recife-PE, Brasil. Metodologia: Foram coletados de registros em prontuário eletrônico os hemogramas de admissão, do segundo dia (D2) e sétimo (D7) dias após internamento em unidades de terapia intensiva (UTI). A relação neutrófilo/linfócito foi calculada pela divisão entre os valores absolutos das contagens celulares. As médias encontradas foram comparadas com: dias de internamento em UTI, tempo de ventilação mecânica, tempo de droga vasoativa e mortalidade em 28 dias. Resultados: O valor médio da relação N/L que teve correlação com mortalidade em 28 dias foi de 14,2 no D1 (p = 0,011) e 15,9 no D7 (p < 0,001). Ao avaliar-se o risco relativo de mortalidade em 28 dias quando os subgrupos foram reunidos em pacientes sem infecção (N/L < 5) e com infecção (N/L = 5), o oddsratio em D1 foi de 12,0; e em D7 foi de 15,8. Conclusão: O valor da relação N/L na avaliação de pacientes sépticos guarda correlação com mortalidade em 28 dias, e valor médio acima de 14 aumenta consideravelmente este risco.
Introduction: Sepsis is a syndrome of systemic inflammatory response associated with infectious outbreak and organ dysfunctions. In the infectious process, the host response is known to increase the number of neutrophils and to reduce the total number of lymphocytes. The neutrophil-to-lymphocyte ratio (NLR) can be easily calculated from the blood count and has been used as a prognostic indicator in several pathologic conditions. This study aimed to evaluate the prognostic value of NLR in septic patients in intensive care units (ICUs) in Recife-PE. Methods: Blood counts on ICU admission and on day 2 (D2) and day 7 (D7) after ICU admission were collected from electronic medical records. The NLR was calculated by dividing the absolute values of cell counts. The resulting averages were compared with length of ICU stay, duration of mechanical ventilation, duration of vasoactive drug use, and 28-day mortality. Results: The mean NLR that correlated with 28-day mortality was 14.2 on D1 (p=0.011) and 15.9 on D7 (p<0.001). In the analysis of the relative risk of 28-day mortality for the subgroups of patients without infection (NLR < 5) and with infection (NLR = 5), the odds ratio was 12.0 on D1 and 15.8 on D7. Conclusion: The value of the NLR in the evaluation of septic patients correlates with 28-day mortality, and mean values above 14 significantly increase this risk.
Asunto(s)
Humanos , Pronóstico , Recuento de Células Sanguíneas , Linfocitos , Síndrome de Respuesta Inflamatoria Sistémica , Sepsis , Neutrófilos , Pacientes , Preparaciones Farmacéuticas , Riesgo , Estudios Retrospectivos , Registros Electrónicos de SaludRESUMEN
The Choosing Wisely Initiative aims to collect statements from medical societies all over the world on medical interventions that result in no benefit to patients, with the potential to cause harm. In this article we present the views of the Diagnostic Laboratory Group at the Brazilian Society of Infectious Diseases (SBI). Ten experts from SBI were asked to list 10 diagnostic tests that were perceived as unnecessary in the field of infectious diseases. After voting for the more relevant topics, a questionnaire was sent to all SBI members, in order to select for the most important items. A total of 482 votes were obtained, and the top 10 results are shown in this manuscript. The Choosing Wisely statements of SBI should facilitate clinical practice by optimizing the use of diagnostic resources in the field of infectious diseases
Asunto(s)
Humanos , Calidad de la Atención de Salud , Enfermedades Transmisibles/diagnóstico , Enfermedades Transmisibles/terapiaRESUMEN
The Choosing Wisely Initiative aims to collect statements from medical societies all over the world on medical interventions that result in no benefit to patients, with the potential to cause harm. In this article we present the views of the Diagnostic Laboratory Group at the Brazilian Society of Infectious Diseases (SBI). Ten experts from SBI were asked to list 10 diagnostic tests that were perceived as unnecessary in the field of infectious diseases. After voting for the more relevant topics, a questionnaire was sent to all SBI members, in order to select for the most important items. A total of 482 votes were obtained, and the top 10 results are shown in this manuscript. The Choosing Wisely statements of SBI should facilitate clinical practice by optimizing the use of diagnostic resources in the field of infectious diseases.
Asunto(s)
Enfermedades Transmisibles/diagnóstico , Sociedades Médicas , Procedimientos Innecesarios/estadística & datos numéricos , Brasil , Salud Global , Investigación sobre Servicios de Salud , HumanosRESUMEN
Esta Nota Técnica apresenta um mapeamento das condições educacionais nas escolas e nos bairros em que se observou a incidência de homicídios em 2014, dentre os 81 municípios que são o foco do PNRH e que concentravam 48,6% dos homicídios do país naquele ano. Traz uma breve discussão do efeito da educação sobre crimes. Detalha a metodologia empregada, incluindo as bases de dados e indicadores utilizados, além de uma descrição das dificuldades para fazer o presente mapeamento. Mostra os resultados de nossos cálculos e, além de relatar os indicadores por escola, por bairro e por cada um dos 81 municípios que compõem o foco principal do pacto, aborda a situação relativa de cada dimensão da escola, em relação a todas as escolas situadas na mesma unidade federativa. Por fim, começa uma reflexão sobre o uso desse documento para motivar um debate sobre os possíveis caminhos e tecnologias que venham a ter efeito para aprimorar as condições educacionais em cada uma das dimensões analisadas nos bairros mais violentos do país, que possivelmente estão nas localidades em que as crianças e jovens se encontram expostos a maiores vulnerabilidades socioeconômicas e deficiência em seus processos educacionais.
Asunto(s)
Causas Externas , Educación , Homicidio , MortalidadRESUMEN
Esta nota possui oito seções centrais. A primeira traz uma análise acerca da evolução dos homicídios nas unidades federativas entre 2004 e 2014. Na segunda seção, produz estimativas para captar a taxa de prevalência de homicídios nas 558 microrregiões do país, em que a correlação espacial é levada em conta de modo a aprimorar a acurácia dos indicadores. Na terceira seção trata de um assunto de crucial importância que versa sobre a letalidade policial e sobre a necessidade de se produzir dados de melhor qualidade pelas organizações. Na quarta, quinta e sexta seções, analisa a evolução da letalidade violenta contra os jovens, negros e mulheres no Brasil, respectivamente. A sétima seção é dedicada à arma de fogo e a sua relação com os homicídios nas unidades federativas. Nessa seção, faz-se um exercício contrafactual para dimensionar a quantidade de homicídios que teríamos hoje, caso o Estatuto do Desarmamento não tivesse sido sancionado em 2003. Na oitava seção, faz algumas considerações sobre a qualidade dos dados sobre agressões (homicídios) do SIM, nas unidades federativas. Para tanto, compara os registros acerca das agressões letais com aqueles das mortes violentas com causa indeterminada e com o total de Crimes Violentos Letais Intencionais, segundo os registros policiais.