Avaliação funcional em pacientes com sequela pulmonar de tuberculose

ResumoIntroduçãoNa tuberculose pulmonar, a presença de lesões pulmonares residuais extensas pode ser um fator preditor de invalidez permanente por conta de insuficiência respiratória.ObjetivoComparar as alterações respiratórias e funcionais em pacientes com sequela pulmonar de tuberculose que finalizaram o tratamento.MétodoO estudo foi realizado no Ambulatório de Tisiologia do Hospital Sanatório Partenon. Foram incluídos no estudo pacientes que finalizaram único tratamento com 6 meses de duração (grupo I) e pacientes com tuberculose pulmonar multirresistente que finalizaram tratamento de maior duração após falência aos tratamentos iniciais (grupo II). Foram avaliadas a função pulmonar através da espirometria (ML 3500 Microlab, Microlab, EUA), a força dos músculos respiratórios através da manovacuometria e a distância percorrida no teste da caminhada dos 6 minutos (TC6M). Os dados foram analisados no programa SPSS versão 13.0, sendo utilizado o teste de qui-quadrado e o t para amostras independentes. O nível de significância adotado foi de 5%.ResultadosForam incluídos 27 pacientes sendo que 12 pertenciam ao grupo de tuberculose multirresistente. O distúrbio ventilatório mais prevalente no grupo de múltiplos tratamentos foi a obstrução grave, presente em 9 pacientes. O grupo que realizou múltiplos tratamentos (grupo II) apresentou redução significativa quando comparado ao grupo I nas variáveis CVF (72,06±14,95 vs. 43,58±16,03% predito), VEF1 (66,13±19,87 vs. 33,08±15,64% predito), PImax (68,40±22,78 vs. 49,58±12,55 cmH2O), PEmax (87,20±27,30 vs. 59,08±12,23 cmH2O) e distância percorrida no TC6M (484,21±74,01 vs. 334,75±104,07 metros).ConclusãoPacientes com tuberculose pulmonar multirresistente que realizaram múltiplos tratamentos apresentam comprometimentos respiratórios e funcionais maiores do que pacientes que realizaram único tratamento.AbstractIntroductionIn pulmonary tuberculosis, the presence of extensive residual lung lesions can be a predictor of permanent disability due to respiratory failure.ObjectiveTo compare functional and respiratory changes in patients with pulmonary tuberculosis sequel who have completed treatment.MethodThe study included patients who completed treatment within a period of 6 months (group I) and multidrug-resistant pulmonary tuberculosis patients who completed treatments of longer duration after the failure of the initial treatment (group II). We evaluated lung function by spirometry (Microlab ML 3500), the strength of respiratory muscles through the manovacuometry (MEP-maximal expiratory pressure and MIP- maximal inspiratory pressure) and the distance walked during the 6-minute walk (6MWT).Results27 patients were included, 12 of whom belonged to group II, multidrug-resistant tuberculosis (MDRTB). Severe combined respiratory disorder was the most prevalent problem in group II of MDRTB; it was present in 9 patients. The MDRTB group (group II) showed significantly lower values when compared to Group I in FVC (72.06±14.95 vs 43.58±16.03% predicted), FEV1 (66.13±19.87 vs 33.08±15.64% predicted), MIP (68.40±22.78 vs 49.58±12.55 cmH2O), MEP (87.20±27.30 vs 59.08±12.23 cmH2O) and distance covered in 6MWT (484.21±74.01 vs 334.75±104.07 meters).ConclusionPatients with multidrug resistant pulmonary tuberculosis who have undergone multiple treatments have more severe respiratory and functional impairment than patients who have had just a single treatment

Preoxidation and adsorption in granular activated carbon for the removal of Diuron and Hexazinone from groundwater

O cultivo da cana-de-açúcar exige a utilização de herbicidas, destacando-se o Diuron e a Hexazinona. Alguns dos poços de abastecimento de Ribeirão Preto (SP) construídos no Aquífero Guarani estão situados em pontos de recarga, e a presença de solo de textura arenosa nessas áreas aumenta a vulnerabilidade da água subterrânea à contaminação por herbicidas. Neste trabalho foram monitorados alguns poços localizados na área de recarga e estudou-se a remoção de Diuron e Hexazinona por meio da adsorção em carvão ativado granular (CAG) e da pré-oxidação com cloro e dióxido de cloro em uma instalação piloto de escoamento contínuo. Verificou-se que o tempo de saturação do CAG no ensaio com a pré-oxidação foi inferior ao obtido no ensaio sem a pré-oxidação com ambos os oxidantes, possivelmente pela formação de subprodutos que competiram com a adsorção dos herbicidas.The cultivation of sugarcane demands the use of herbicides such as Diuron and Hexazinone. Some supply wells from Ribeirão Preto, SP, Brazil, built in the Guarani Aquifer are located in recharge points, and the presence of sandy Quartzarenic Neosol in these areas increases the vulnerability of the groundwater to contamination from herbicides This paper reports the water quality monitored in some wells located in the recharge area and the removal of Diuron and Hexazinone by means of adsorption in granular activated carbon (GAC), preceded or not by preoxidation with chlorine and chlorine dioxide in a pilot plant. The results indicated that Diuron was more strongly adsorbed than Hexazinone and that the saturation time of the GAC in the test with preoxidation was shorter than in the test without preoxidation, which may have occurred mainly due to the formation of by-products that competed with the adsorption of the herbicides.FINEP - Estudos e ProjetosConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Effective deep learning training for single-image super-resolution in endomicroscopy exploiting video-registration-based reconstruction

PURPOSE: Probe-based confocal laser endomicroscopy (pCLE) is a recent imaging modality that allows performing in vivo optical biopsies. The design of pCLE hardware, and its reliance on an optical fibre bundle, fundamentally limits the image quality with a few tens of thousands fibres, each acting as the equivalent of a single-pixel detector, assembled into a single fibre bundle. Video registration techniques can be used to estimate high-resolution (HR) images by exploiting the temporal information contained in a sequence of low-resolution (LR) images. However, the alignment of LR frames, required for the fusion, is computationally demanding and prone to artefacts. METHODS: In this work, we propose a novel synthetic data generation approach to train exemplar-based Deep Neural Networks (DNNs). HR pCLE images with enhanced quality are recovered by the models trained on pairs of estimated HR images (generated by the video registration algorithm) and realistic synthetic LR images. Performance of three different state-of-the-art DNNs techniques were analysed on a Smart Atlas database of 8806 images from 238 pCLE video sequences. The results were validated through an extensive image quality assessment that takes into account different quality scores, including a Mean Opinion Score (MOS). RESULTS: Results indicate that the proposed solution produces an effective improvement in the quality of the obtained reconstructed image. CONCLUSION: The proposed training strategy and associated DNNs allows us to perform convincing super-resolution of pCLE images

Zero-shot super-resolution with a physically-motivated downsampling kernel for endomicroscopy

Super-resolution (SR) methods have seen significant advances thanks to the development of convolutional neural networks (CNNs). CNNs have been successfully employed to improve the quality of endomicroscopy imaging. Yet, the inherent limitation of research on SR in endomicroscopy remains the lack of ground truth high-resolution (HR) images, commonly used for both supervised training and reference-based image quality assessment (IQA). Therefore, alternative methods, such as unsupervised SR are being explored. To address the need for non-reference image quality improvement, we designed a novel zero-shot super-resolution (ZSSR) approach that relies only on the endomicroscopy data to be processed in a self-supervised manner without the need for ground-truth HR images. We tailored the proposed pipeline to the idiosyncrasies of endomicroscopy by introducing both: a physically-motivated Voronoi downscaling kernel accounting for the endomicroscope’s irregular fibre-based sampling pattern, and realistic noise patterns. We also took advantage of video sequences to exploit a sequence of images for self-supervised zero-shot image quality improvement. We run ablation studies to assess our contribution in regards to the downscaling kernel and noise simulation. We validate our methodology on both synthetic and original data. Synthetic experiments were assessed with reference-based IQA, while our results for original images were evaluated in a user study conducted with both expert and non-expert observers. The results demonstrated superior performance in image quality of ZSSR reconstructions in comparison to the baseline method. The ZSSR is also competitive when compared to supervised single-image SR, especially being the preferred reconstruction technique by experts

Central Diabetes Insipidus in a Young Feline

Background: Central diabetes insipidus (CDI) is an endocrine disorder caused by the failure to produce, transport, or release ADH. This disease may show a primary etiology (idiopathic or congenital) or a secondary one (trauma or neoplasms). It is characterized by signs such as polyuria and polydipsia. The definitive diagnosis is obtained by the two-step water deprivation test; the absence of adequate urinary concentration in the first stage confirms the diagnosis of diabetes insipidus and, in the second stage, the response to the application of synthetic desmopressin confirms a central origin. Because CDI is rare in felines, the aim of this study was to report the occurrence of a case of CDI, probably of congenital primary origin, in an 8-month-old kitten.Case: An 8-month-old male feline, castrated, 3.2 kg, was brought to consultation with a report of polydipsia, polyuria, smaller size and weight, and lower activity when compared to his brother, for several months. On physical examination, lethargy, body score 2/5, and mild dehydration were noted, as well as deciduous teeth that should have already been replaced. Abdominal ultrasound and laboratory tests were requested, which ruled out chronic kidney disease (CKD), diabetes mellitus (DM), hyperadrenocorticism (HAC), and hyperthyroidism. Due to the fact that urinalysis evidenced hyposthenuria (urinary density [UD] 1.004), CDI was suspected. The patient underwent a water  deprivation test and, after 7.5 h, lost 4.7% of his initial weight, while UD was 1.012, confirming the diagnosis of DI. The investigation then proceeded to the evaluation of the response to synthetic desmopressin by the application of 5 U IM. Two h later, UD was 1.019, confirming the diagnosis of CDI. The prescribed treatment was oral desmopressin at a dose of 100 μg BID. Upon return after 30 days, the feline had gained weight, was well hydrated, and the tutor reported higher activity. A new urinalysis showed a UD of 1.004 and inactive sediment. The tutor was asked to start administering the drug three times a day. However, noting that the patient’s quality of life had significantly improved, and wishing to spare the animal from the stress of taking medication once more a day, she chose not to modify the therapy and not to perform additional tests, due to financial limitation.Discussion: First, CKD, DM, HAC, and hyperthyroidism, more common conditions, were ruled out, and the investigation then proceeded to a water deprivation test. The feline lost 3% to 5% of the initial weight and UD was on the borderlinebetween hypo- and isosthenuria, as described in the literature for the diagnosis of DI. In the second stage of the test, slight urinary concentration was observed after the application of synthetic desmopressin, which confirmed the diagnosis of CDI. The dose of desmopressin prescribed for home treatment, 100 μg BID, was effective to relieve the clinical signs, but urine remained in hyposthenuria in the interval between administrations, suggesting that, for this patient, treatment would be more effective by administering the medication three times a day, in order to maintain an adequate serum concentration. Due to the diagnosis of CDI and the feline being young, the condition’s primary origin is believed to be congenital. It is also suspected that the patient may still have congenital hypothyroidism, due to the clinical signs of late tooth exchange and constant lethargy, in addition to laboratory results of thyroid hormones below reference levels. However, because thyroid tests were made by chemiluminescence, a repetition by radioimmunoassay is indicated. If hypothyroidism is confirmed,it would be possible to assume a common etiological factor between CDI and hypothyroidism, such as hypothalamicpituitary malformation

Formation of halogenated organic byproducts using preoxidation with chlorine, ozone and peroxone and post-chlorination of water containing humic substances

Dentre os compostos orgânicos halogenados que podem ser encontrados na água distribuída à população, destacam-se: trialometanos, ácidos haloacéticos, haloaldeídos, halocetonas, halofenóis e halopicrinas. O presente trabalho teve como objetivo avaliar o efeito da formação de 22 subprodutos com a utilização dos pré-oxidantes: cloro, ozônio e peroxônio. A formação de subprodutos foi observada em água preparada com adição de substâncias húmicas extraídas de solo turfoso, por meio do uso da pré-oxidação, presença e ausência de coagulação, filtração e pós-cloração. Os subprodutos foram quantificados por cromatografia gasosa com detetor de captura de elétrons. Os resultados obtidos mostraram que o uso de pré-oxidantes alternativos, ozônio e peroxônio, associados à coagulação, filtração e pós-cloração, formam quantidades pequenas de subprodutos.When chlorine is used as preoxidant, the formation of halogenated organic byproducts found in water treated and distriduted to the population, are: trihalometane, haloacetic acids, haloaldehyde, haloketone, halophenol and halopicrin. This research was performed to evaluate the formation potential of 22 byproducts using the following preoxidants: chlorine, ozone and peroxone. The formation of byproducts was simulated in water prepared with the addition of humic substances extracted from peat soil by the use of preoxidants, coagulation, filtration, and post-chlorination. Byproducts have quantified by gas chromatography with electron capture detector. The results obtained showed that the use of alternative preoxidants, such as ozone and peroxone, associated with coagulation, filtration, and post-chlorination form a low concentration of byproducts.FAPES

Inundation Risk Index as an Urban Planning Supportive Tool

Urban densification and severe housing deficit of the low and middle-income population have been worsening as the urbanization process grew. It is not uncommon that lower income population finds some shelter irregularly occupying riverine areas. Today, flood risk processes associated with river dynamics generate significant expenses and concerns for public management. In view of this, the main objective of this work is to develop a flood risk supporting tool, which deals with some of the current urban planning drawbacks, being simple and accessible even to cities with little technical and investment capacities. This tool results from a multi-criteria analysis, and it is represented by a quantitative index, called the Inundation Risk Index, varying from 0 to 100. This new index is capable of combining factors related to both the natural characteristics of the watershed, which respond to the physical susceptibility to flooding, simulating the hazard, and to socioeconomic characteristics of the population and of the region affected, representing the vulnerability. Once normalized, each of the factors that compose the index is operated, in a relatively simple formulation, composed of weighted sums and weighted products. The Inundation Risk Index was applied to a case study in the Bacanga river basin, in the municipality of São Luís-Maranhão State/Brazil. In this work, was used a hydrodynamic model to validate the hazard component of the index. The results obtained by the mathematical modeling are consistent with the situation measured by Inundation Risk Index, which are also consistent with real practical observations and historical reports

Charge dynamics in half-filled Hubbard chains with finite on-site interaction

We study the charge dynamic structure factor of the one-dimensional Hubbard model with finite on-site repulsion U at half filling. Numerical results from the time-dependent density matrix renormalization group are analyzed by comparison with the exact spectrum of the model. The evolution of the line shape as a function of U is explained in terms of a relative transfer of spectral weight between the two-holon continuum that dominates in the limit U\to \infty and a subset of the two-holon-two-spinon continuum that reconstructs the electron-hole continuum in the limit U\to 0. Power-law singularities along boundary lines of the spectrum are described by effective impurity models that are explicitly invariant under spin and \eta-spin SU(2) rotations. The Mott-Hubbard metal-insulator transition is reflected in a discontinuous change of the exponents of edge singularities at U=0. The sharp feature observed in the spectrum for momenta near the zone boundary is attributed to a Van Hove singularity that persists as a consequence of integrability.Comment: 22 pages, 13 figure