Effectiveness Analysis of Biomedical Dynamometers used to evaluate palmar gripping force and forceps gripping in Leprosy Carriers

Leprosy is a chronic and infectious disease, transmissible, which causes neural lesions in which its investigation is mandatory in Brazil because it causes decreased thermal sensitivity, touch and pain, but mainly causes loss of muscle strength in the feet and hands giving the disease a great disabling power. Therefore, this disease is of health concern and control policies have been concerned with early diagnosis and treatment of affected individuals, requiring objective, sensitive and reliable methods of measurement. Therefore, this research proposed to analyze the effectiveness of biomedical dynamometers in the measurement of handgrip strength and forceps grasping force in the hand of leprosy patients. In this context, a systematic literature review was performed considering publications in Portuguese and English from 1993 to 2019, due to the lack of qualitative research publications in recent years related to the measurement of the effects of leprosy. The results of the study showed that the dynamometers surveyed have the potential to be used as tools to measure effects and support the diagnosis of leprosy. These meters have important features such as non-invasive, easily reproduced and good accuracy, contributing to objective assessment and early diagnosis of the professional, favoring the treatment of affected patients. In addition, through this literature review, it is possible to observe the importance of handgrip strength measurement, because the delay in diagnosis and consequently in treatment generates severe physical disabilities in the hands, which are evident due to the radial, median and ulnar nerves generating limitation to perform activities and decreased work capacity

Development of Biomedical Dynamometer for Measurement of Grip Strength in Mice Modeled with Cerebral Palsy

This research aimed to develop a biomedical dynamometer capable of measuring the grip strength of the forepaws of laboratory mices to verify the posterior phase, the effect of modeled cerebral palsy in the animal. The equipment was developed using a stainless steel blade, two double strain gages, a signal conditioning circuit that was connected to a software for acquisition, processing and plotting of graphs and tables in Excel. The metal blade has a length of 18.5 cm, a width of 1.5 cm and a thickness of 2 mm and a double strain gage model pa-09-125ha-350-l8 from Excel Sensors (Brazil), was glued to each face. The two double strain gages were connected in a Wheatstone bridge, which produces an analog response due to mechanical deformation of the blade, with force applied by the mice. This response was submitted to a signal conditioning circuit developed with Arduino that modulated the input wave, generated 10000 times amplification and performed filtering 4th order using Butterworth filter. Finally, a software developed in Labview 2019 of National Instruments (USA) was used for acquisition, processing and plotting of graphs and tables in Excel of the measurements performed. In the next step, the dynamometer was calibrated for sequential loading of masses of 0, 15.48 g, 31.53 g, 46.88 g to 62.47 g and also for sequential unloading of the same masses. For this, the masses were hung on a nylon string that was attached to the free end of the metal sheet. The final test was to measure the response time of the dynamometer with a stopwatch, when hanging a mass of 62.47 g on the nylon thread that was cut abruptly with scissors. Some of the main results of the calibration were as follows: 15.48 g generated 3.70 V, 31.53 g generated 7.48 V and 62.47 g gene rated 14.80 V and the response time was 0.3 s. These answers show that the dynamometer can be used to measure the grip strength of mice and can be modified for use in humans

Biomedical Mechatronic Dynamometer to Support the Evaluation of the Effects of Leprosy Through the Palmar Holding Strenght and the Tweezer Holding Strenght

The hand can suffer the effects of several diseases among the most serious, leprosy stands out, which is considered infectious and can generate loss of muscle strength, atrophy, deformity and physical, mental and social disability. For the World Health Organization (WHO) and also doctors and physiotherapists, it is necessary to evaluate the diseases in an objective, reliable and early manner in order to propose appropriate treatment and follow their evolution. This research proposed a biomedical mechatronic dynamometer in order to support the evaluation of the effects of leprosy by means of palmar grip strength and grip strength of tweezers performed by hand. The experimental research was developed at the Federal University of Mato Grosso do Sul and consisted first of all in the survey of the demands of the health area in relation to the biomedical dynamometer being consulted the following databases: Medical Literature Analysis and Retrieval System Online (Medline); US National Library of Medicine National Institutes of Health (PUBMED) e Institute of Electrical and Electronic Engineers (IEEE). The mechatronic biomedical dynamometer consisted of three fundamental parts: mechanical structure, electronic signal conditioning circuitry and digital information processing. The mechanical structure was designed to withstand a strenght of up to 700 N, developed in brass because this metal has low cost, has less mass and also because it is easier to machine than steel. The oval shape of the structure contains two lateral and thin regions that measure 2 cm thick, 3 cm wide each and aim to concentrate mechanical stresses in order to sensitize the strain sensor consisting of the four linear strain gages, model N2A-XX-S5262P-350/E4 and nominal resistance of 350 Ω, from the company Micro-Measurements, which showed accuracy of 98%. The mechanical structure also has a stainless-steel support that measures 1 cm thick and 3 cm wide located at the bottom and on which was glued a cushion to support the palm of the hand. This support can be replaced by other models that also contain a cushion that considers the presence of injuries or deformities in the hand. The mechanical structure also has a upper support that also measures 1 cm thick and 3 cm wide, to which four pressure sensors developed with rosette strain gages model N2K-XX-S5294R-350/DP/E4 with a nominal resistance of 350 Ω, from the company Micro-Measurements, were fixed and which showed an accuracy of 99.5%. The deformation sensor is stimulated by the application of palmar grip strenght while the pressure sensors are stimulated by the realization of index, middle, annular and minimum finger gripping strenght. In addition, these sensors are connected to Wheatstone Bridges whose feeds and also the responses are processed by five signal conditioning circuits developed with operational amplifiers LF 356, OPA 27 and OP27 GP of the company Burr-Brown, whose structure consists of voltage oscillator, amplifier, band pass filter, buffer and peak detector that generates DC voltage that feeds the data acquisition board. The answers on this board are sent to the Inspiron 15 3000 microcomputer from Dell, which has installed Labview software from National Instruments, which processes the information, stores, plotts the palmar grip strenght and pinch grip strenght graphs and can also send the information over the Internet. This research has the potential to obtain accurate information on the effects of leprosy in the hand that can support the evaluation, diagnosis of health professionals, follow up the evolution of the disease and the treatment adopted

Cuidados da medicina de precisão para o transtorno do espectro autista / Precision medicine care for autistic spectrum disorder

O objetivo deste estudo de revisão integrativa de literatura é investigar a medicina de precisão aplicada no diagnostico, classificação da gravidade e tratamento do espectro autista. Para melhor discutir as publicações e materiais levantados no estudo, a presente pesquisa foi organizada em três unidades temáticas que descrevem como a medicina de precisão é utilizada no diagnostico e melhoria da qualidade de vida de pessoas com transtorno do espectro autista no Brasil e no mundo. Embora existam critérios de diagnósticos clínicos e genéticos bem definidos, os limiares clínicos e o reconhecimento da gravidade do fenótipo podem variar infinitamente entre médicos, além disso, o impacto dessas variações não está explícito nos protocolos aplicados para o diagnóstico, classificação e tratamento do TEA. A medicina de precisão aliada à inteligência artificial tem possibilitado a identificação de variantes somáticas com potencial de impactar na gravidade fenotípica do TEA, estes estudos podem possibilitar a detecção de moléculas alvo, existentes na grande parte dos genes mutantes. Inclusive, detectando mutações somáticas sofridas pelos neurônios

Uso de CPAP para apnéia obstrutiva do sono comparadas ao tratamento conservador / CPAP use for obstructive sleep apnea compared to conservative treatment

Introdução: A apneia obstrutiva do sono (AOS) tornou-se um grande problema de saúde pública, por ser um distúrbio do sono, que resulta em ronco e riscos nocivos para a saúde. A baixa adesão ao tratamento conservador tem dado espaço para a criação de novos dispositivos. Objetivo: comparar custos, funcionalidade, durabilidade e eficiência de tecnologias assistivas aliadas ao tratamento conservador da AOS. Método: A pesquisa exploratória e descritiva foi realizada nas bases National Library of Medicine (PubMed), Web of Science, Scopus, Biblioteca Virtual em Saúde (BVS) e IEEEXplore. Como descritores e palavras-chaves, com o operador booleano “AND” ou “OR”, foram pesquisados os termos “spleep apnea” and “assistive technology” or “self-help devices” or “devices”. Resultados: A pressão positiva contínua nas vias aéreas (CPAP) representa o método padrão-ouro, porém, possui baixa aceitabilidade pelos pacientes com AOS devido a limitação da funcionalidade. O aparelho de avanço mandibular (MAA) é  reconhecido como uma opção de terapia de primeira linha para a AOS leve a moderada apresentando variedade em relação à custo, benefício e durabilidade. O  uso de terapia oral com aparelho (OAT) a longo prazo foi associado a alterações dentárias. Conclusão: Constatou-se a variedade de dispositivos para AOS, ressaltando a necessidade de avaliação da realidade do paciente, sendo de suma importância avaliar o custo-benefício, os sintomas e principalmente, prestar orientações assertivas para a melhor escolha dos dispositivos, sendo o dispositivo de avanço mandibular (MAD), o que apresentou melhor adesão. Ressalta-se a necessidade de novos estudos para melhores intervenções, pois protótipos não substituem tratamentos comprovados

The use of assistive technological tools in people with depression arising from the Covid Pandemic

Depression is a disease that affects approximately 60 million people in the world each year, affecting around 11.5 million Brazilians, which presents in the individual severe anxiety disorders, which may evolve into cases of suicide, ranking among the 20 major causes of death/ year. As a result of Covid-19, approximately 90% of cases of depression in Brazil in the last year increased and people with anxiety crisis and symptoms of acute stress doubled in 2020, and this increases concerns regarding the social isolation that extends. This study aimed to investigate the resources of assistive technologies applied to depressive cases with potential application as treatment mechanisms in the context of the COVID-19 pandemic. This is a study with an exploratory objective, a quantitative approach and a bibliographic procedure and descriptors databases. The study evaluated the presence of 306 articles, being used as a filter the interval between 5 and 10 years of publication. The tools used to depression acquired during the pandemic were also discussed, where the results contributed to broader reflections on the challenges imposed by the pathology. Some interesting results were obtained with the application of Tec. Assistive (AT) depressed patients by Covid-19, highlighting: remote care, electroconvulsive therapy, Deprexis, in addition to art therapy and music therapy, the latter being calls for integrative and complementary practices in health (PICs) with application encouraged by SUS showing great relevance and effectiveness in the treatment. The research carried out has shown the potential of ED tools to address the effects of depression in people with Covid-19. This study encourages the development of new research and the development of instruments that are more specific to this need in order to minimize the problems arising from this disease

AUTONOMIA DAS PESSOAS COM DEFICIÊNCIA VISUAL EM INSTITUIÇÕES DE ENSINO SUPERIOR

A deficiência visual é a deficiência mais prevalente no Brasil. Embora haja um incentivo por parte de políticas governamentais para que se amplie o acesso à educação, sabe-se que a adaptação de ambientes à estes indivíduos ainda é precária. Assim, o objetivo deste artigo é discorrer sobre a importância das pessoas com deficiência visual no ensino superior e as diferentes ferramentas que podem ser implantadas nestas instituições com o objetivo de ampliar a acessibilidade a estes locais. Realizou-se uma revisão simples de literatura, com busca nas bases de dados Scielo, Lilacs e Google Acadêmico. Estes indivíduos necessitam de um ensino superior adaptado para que se possibilite maior inclusão e aumento da autonomia. Destaca-se o uso de dispositivos móveis, a presença de pisos táteis, materiais em formato eletrônico, o preparo dos educadores para trabalhar com este público, bem como o treinamento prévio do deficiente visual para fazer uso destas ferramenta

The use of personalized medicine combined with artificial intelligence to monitor people with Covid-19

Since the emergence of the pandemic caused by the SARS-CoV-2 virus (coronavirus disease or COVID-19), the generalities since its emergence, from the clinical picture, as well as the findings observed in AI (Artificial Intelligence) diagnostic methods applied to medicine personalized. This article is a literature review regarding the use of personalized medicine combined with artificial intelligence to monitor people with covid-19. The continuous evolution of intelligent systems aims to provide better reasoning and more efficient use of collected data. This use is not restricted to retrospective interpretation, that is, to provide diagnostic conclusions. It can also be extended to prospective interpretation, providing an early prognosis. That said, physicians who could be assisted by these systems find themselves in the gap between the clinical case and in-depth technical analyses. What is missing is a clear starting point for approaching the world of machine learning in medicine

Inclusion of students with down syndrome in Brazilian schools

Down syndrome, or chromosome 21 trisomy, is a genetic change that occurs at the time of conception of a child. People with Down syndrome have intellectual disabilities, this fact contributes to social exclusion, isolation and impairment in their development, since there is much social prejudice regarding this syndrome. Considering the need to include children with Down Syndrome In schools this research aimed to promote a reflection on the process of inclusion of these people in Brazilian schools through the assistive technologies used. This research is an integrative literature review where the search took place in databases of greater relevance to the subject. The exact descriptors of medical subject titles were used in English using "Mainstreaming (Education)", "Down Syndrome" and "Schools" and in Portuguese the exact descriptors in the health sciences "Educational Inclusion", "Down Syndrome" and Schools”. The results showed that the insertion of the child is only physical and only due to the obligation promoted by the current national legislation. Social inclusion does not occur in such a way as to integrate students, teachers and technicians, and teachers are unprepared to drive inclusion due to limitations in their education, lack of incentive to qualification, school infrastructure and large numbers of students in the classroom. In accordance with this reality, this paper aims to promote a reflection on the inclusion of students with Down syndrome in Brazilian schools, through the discussion and development of appropriate assistive technologies for this process to occur effectively

The Work of The Deaf teacher at The University

The deaf teacher is a professional who differs from another in the way he communicates, and the language used by these professionals is the Brazilian Sign Language (LIBRAS). The objective: to verify the inclusion of deaf teachers in higher education as well as to verify the assistive technologies that contribute to this process and the reality of these professionals. The methodology was a literature review of articles published between 2009 and 2017. Data werecollected from the following databases: Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SCIELO) and National Library of Medicine (PUBMED), using the keywords: teachers, deafness, universities, inclusion, assistive technologies and disability. The results showed that the inclusion of deaf teachers in higher education occurs due to the laws that determine the appointment of deaf teaching professionals as priorities for teaching LIBRAS courses in universities, being LIBRAS an Assistive Technology (TA) for the inclusion of these professionals. However, deaf teachers showed isolation due to the difficulty of communication with other teachers, having difficulties to exchange experiences beyond the strangeness of the students, about the didactics, methodology and evaluation of the deaf teacher