Ensino de tecnologia assistiva nos cursos de graduação em terapia ocupacional do Estado de São Paulo / Teaching assistive technology in undergraduate courses in occupational therapy in the State of São Paulo

Resumo Introdução O conhecimento sobre tecnologia assistiva relaciona-se aos aspectos do domínio da terapia ocupacional, assim, interroga-se se tal conhecimento tem sido abordado nos cursos de graduação. Objetivos Identificar os cursos de graduação em terapia ocupacional no estado de São Paulo que ofertam discipinas referentes à tecnologia assistiva, identificar as disciplinas, suas respectivas cargas horárias e o conteúdo presente em cada uma delas. Método A amostra foi composta por oito universidades, cinco públicas e três privadas. A busca foi feita nas matrizes curriculares, planos de ensino de disciplinas específicas e não específicas, objetivos e conteúdos disponibilizados on-line ou solicitados ao coordenador de curso. Realizou-se análise descritiva dos dados. Resultados Constatou-se a oferta do conteúdo de tecnologia assistiva nas universidades investigadas, com diferença entre a carga horária e o conteúdo ofertado. A análise por área de aplicação da tecnologia assistiva evidenciou que o conteúdo sobre órteses é oferecido em 100% dos cursos analisados, seguido de produtos assistivos para o desempenho de atividades cotidianas e de prótese, ambos conteúdos encontrados em 75% dos cursos; equipamentos para mobilidade; acessibilidade e desenho universal em 62,5%; comunicação alternativa em 50% dos cursos. Conclusão Os resultados apontam a relevância de uma maior homogeneidade de conteúdo entre as universidades investigadas e sugerem que este estudo tem potencial para fomentar discussões sobre a formação do terapauta ocupacional na área da tecnologia assistiva, uma vez que os resultados advêm da análise dos cursos de graduação localizados no estado que possui o maior número de cursos de terapia ocupacional no Brasil.

Abstract Introduction Knowledge about assistive technology is related to aspects of the field of occupational therapy, thus, it is questioned whether such knowledge has been addressed in undergraduate courses. Objectives To identify the undergraduate courses in occupational therapy in the state of São Paulo that offer disciplines related to assistive technology, identify the disciplines, their respective workloads and the content present in each of them. Method The sample consisted of eight universities, five public and three private. The search was made in the curricular matrices, teaching plans of specific and non-specific disciplines, objectives and contents available online or requested from the course coordinator. Descriptive data analysis was performed. Results It was found that assistive technology content was offered in the investigated universities, with a difference between the workload and the content offered. The analysis by assistive technology application area showed that the content on orthoses is offered in 100% of the analyzed courses, followed by assistive products for the performance of daily activities and prostheses, both contents found in 75% of the courses; mobility equipment; accessibility and universal design in 62.5%; alternative communication in 50% of the courses. Conclusion The results point to the relevance of greater homogeneity of content between the investigated universities and suggest that this study has the potential to foster discussions about the formation of occupational therapists in the assistive technology area, since the results come from the analysis of undergraduate courses located in the state which has the largest number of occupational therapy courses in Brazil.

Molecular Epidemiology of blaKPC-Encoding Klebsiella pneumoniae Isolated from Public Hospitals in Midwest of Brazil.

This study was conducted to determine the molecular epidemiology of blaKPC-encoding Klebsiella pneumoniae recovered from three public hospitals in Brazil. Molecular investigation of blaOXA-48, blaKPC, blaNDM, blaCTX-M, blaSHV, blaTEM, blaIMP, and blaVIM resistance genes was performed in 99 K. pneumoniae isolates from inpatients of intensive care units. Antimicrobial susceptibility was determined with a Vitek-2 System, except for polymyxin B, which was evaluated by the microbroth dilution test. Clonal relatedness was established by pulsed-field gel electrophoresis and multilocus sequence typing. Screening resistance genes showed that K. pneumoniae isolates carried the blaKPC (88.9%), blaSHV (73.5%), blaTEM (72.2%), and blaCTX-M (43.9%) genes. The most frequent sequence types (STs) were ST273, ST11, ST 1298, ST13, ST2687, and ST37. We report new STs in K. pneumoniae that have not been detected previously in Brazil. K. pneumoniae belonging to the same clone is present in different hospitals in the same region, showing the spread of multidrug-resistant K. pneumoniae.

Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases.

Nosocomial bacterial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is associated with high mortality in neurosurgical patients. There are few reports in the literature on meningitis caused by CRKP. We report two cases of CRKP meningitis after neurosurgery. The K. pneumoniae identification and antimicrobial susceptibility testing were performed using the Vitek Compact System. Minimum inhibitory concentrations of polymyxin B were determined using the broth microdilution method. Molecular typing of K. pneumoniae isolates was investigated using multilocus sequence typing. Antimicrobial susceptibility testing showed that the K. pneumoniae isolates were multidrug resistant and co-produced extended-spectrum ß-lactamases and KPC enzymes. The patients were treated with intrathecal polymyxin. Genetic polymorphism analyses revealed two different K. pneumoniae clones (ST1298 and ST2687), which were observed for the first time in CRKP infections. We recommend intravenous administration of intrathecal polymyxin for treating meningitis caused by multidrug-resistant K. pneumoniae .

Non-clonal occurrence of pmrB mutations associated with polymyxin resistance in carbapenem-resistant Klebsiella pneumoniae in Brazil.

BACKGROUND: Polymyxins are currently used as a "last-line" treatment for multidrug-resistant Gram-negative infections. OBJECTIVES: To identify the major mechanisms of resistance to polymyxin and compare the genetic similarity between multi-drug resistant Klebsiella pneumoniae strains recovered from inpatients of public hospitals in the Mid-West of Brazil. METHODS: 97 carbapenems non-susceptible K. pneumoniae were studied. ß-lactamases (bla OXA-48, bla KPC, bla NDM, bla CTX-M, bla SHV, bla TEM, bla IMP, bla VIM) and mcr-1 to mcr-5 genes were investigated by polymerase chain reaction (PCR). Mutations in chromosomal genes (pmrA, pmrB, phoP, phoQ, and mgrB) were screened by PCR and DNA sequencing. Clonal relatedness was established by using pulsed-field gel electrophoresis and multilocus sequence typing. FINDINGS: K. pneumoniae isolates harbored bla KPC (93.3%), bla SHV (86.6%), bla TEM (80.0%), bla CTX-M (60%) genes. Of 15 K. pneumoniae resistant to polymyxin B the authors identified deleterious mutations in pmrB gene, mainly in T157P. None K. pneumoniae presented mcr gene variants. Genetic polymorphism analyses revealed 12 different pulsotypes. MAIN CONCLUSIONS: Deleterious mutations in pmrB gene is the main chromosomal target for induction of polymyxin resistance in carbapenem-resistant K. pneumoniae in public hospitals in the Mid-West of Brazil.

Melioidosis, an emerging infectious disease in the Midwest Brazil: A case report.

RATIONALE: Melioidosis is an emerging infectious disease in Brazil and caused by Burkholderia pseudomallei, with high morbidity and mortality rates. A total of 28 melioidosis cases were reported in Brazil until 2015. The majority of melioidosis cases were reported in the Northwest region of Brazil and such cases were not previously detected in the Midwest region of Brazil. PATIENT CONCERNS: A 42-year-old man was admitted with a non-productive cough, dyspnea, myalgia, diffuse abdominal pain. Pulmonary auscultation revealed a vesicular murmur, snoring sounds, and the presence of basal crackling rales in the left hemithorax. The patient evolved with several respiratory failures and he was diagnosed as the first case of community-acquired pneumonia with sepsis caused by B pseudomallei in Mato Grosso do Sul, Midwest state of Brazil. DIAGNOSIS: The cell isolates were subjected to 16S rRNA gene sequencing to confirm the bacterial species. INTERVENTIONS: Administration of trimethoprim/sulfamethoxazole and meropenem stabilized the clinical condition of the patient. Subsequently upon discharge, the patient was also treated with trimethoprim/sulfametothoxazole for a year. OUTCOME: We reported the first case of community-acquired pneumonia with sepsis caused by B pseudomallei in Mato Grosso do Sul, Midwest state of Brazil and the patient survived. LESSONS: The emergence of melioidosis in the Midwest region is being neglected and underestimated and melioidosis must be considered of the differential diagnosis in community infections.

Non-clonal occurrence of pmrB mutations associated with polymyxin resistance in carbapenem-resistant Klebsiella pneumoniae in Brazil

BACKGROUND Polymyxins are currently used as a "last-line" treatment for multidrug-resistant Gram-negative infections. OBJECTIVES To identify the major mechanisms of resistance to polymyxin and compare the genetic similarity between multi-drug resistant Klebsiella pneumoniae strains recovered from inpatients of public hospitals in the Mid-West of Brazil. METHODS 97 carbapenems non-susceptible K. pneumoniae were studied. β-lactamases (bla OXA-48, bla KPC, bla NDM, bla CTX-M, bla SHV, bla TEM, bla IMP, bla VIM) and mcr-1 to mcr-5 genes were investigated by polymerase chain reaction (PCR). Mutations in chromosomal genes (pmrA, pmrB, phoP, phoQ, and mgrB) were screened by PCR and DNA sequencing. Clonal relatedness was established by using pulsed-field gel electrophoresis and multilocus sequence typing. FINDINGS K. pneumoniae isolates harbored bla KPC (93.3%), bla SHV (86.6%), bla TEM (80.0%), bla CTX-M (60%) genes. Of 15 K. pneumoniae resistant to polymyxin B the authors identified deleterious mutations in pmrB gene, mainly in T157P. None K. pneumoniae presented mcr gene variants. Genetic polymorphism analyses revealed 12 different pulsotypes. MAIN CONCLUSIONS Deleterious mutations in pmrB gene is the main chromosomal target for induction of polymyxin resistance in carbapenem-resistant K. pneumoniae in public hospitals in the Mid-West of Brazil.

Photoacclimation strategies in northeastern Atlantic seagrasses: Integrating responses across plant organizational levels.

Seagrasses live in highly variable light environments and adjust to these variations by expressing acclimatory responses at different plant organizational levels (meadow, shoot, leaf and chloroplast level). Yet, comparative studies, to identify species' strategies, and integration of the relative importance of photoacclimatory adjustments at different levels are still missing. The variation in photoacclimatory responses at the chloroplast and leaf level were studied along individual leaves of Cymodocea nodosa, Zostera marina and Z. noltei, including measurements of variable chlorophyll fluorescence, photosynthesis, photoprotective capacities, non-photochemical quenching and D1-protein repair, and assessments of variation in leaf anatomy and chloroplast distribution. Our results show that the slower-growing C. nodosa expressed rather limited physiological and biochemical adjustments in response to light availability, while both species of faster-growing Zostera showed high variability along the leaves. In contrast, the inverse pattern was found for leaf anatomical adjustments in response to light availability, which were more pronounced in C. nodosa. This integrative plant organizational level approach shows that seagrasses differ in their photoacclimatory strategies and that these are linked to the species' life history strategies, information that will be critical for predicting the responses of seagrasses to disturbances and to accordingly develop adequate management strategies.

Strategies for Developing Students' Empathy and Awareness for the Needs of People with Disabilities: Contributions to Design Education.

The design of products for people with disabilities requires the understanding of a wide range of factors related to users' health, functional abilities, needs, expectations and preferences. Such multifactorial perspective is often perceived as beyond the reach by the students of both graphic and product design, as it comprises knowledge from different areas such are not usually part of design curriculum as health, rehabilitation, computer science and biomedical engineering. Here, we report on strategies for developing design students' empathy and awareness for the needs and expectations of people with disabilities. By means of a combination of theoretical and practical approaches, a course on Inclusive Design was developed as part of the regular curriculum of the Bachelor Programme in Design at Sao Paulo State University (UNESP, Bauru campus, Brazil), with the collaborative participation of members of SORRI BAURU Rehabilitation Center. The final projects developed by the students were based on the demands presented by SORRI BAURU's rehabilitation team, and results reveal that the theoretical-practical approach based on interdisciplinarity was shown to provide the design students a learning experience that, ultimately, supports the quality decision-making in the design process. This paper describes the pedagogical approach, theoretical contents and practical activities developed during the Inclusive Design course. The challenges, benefits, results, and contributions of this experience from the perspective of the design education are also discussed.

Evaluation of environmental effects on reproductive characteristics of Mangalarga Marchador mares in a commercial embryo transfer program.

The objective of this study was to evaluate the environmental effects on embryo recovery rate and pregnancy rate of Mangalarga Marchador mares. The reproductive characteristics of donor and recipient mares were evaluated during five years in Brazilian tropical environment. The mares were used throughout the year and seasons were classified as: October to April (breeding season - BS); May (autumn transition out of the breeding season - ATBS); June to August (non-breeding season - nBS); and September (vernal transition into the breeding season - VTBS). Daily temperature rainfall and hours of daylight (photoperiod) were measured during all months and years of evaluation. The embryo recovery rate (ERR) and the pregnancy rate (PR) were observed and frequencies were calculated. The effect of environmental variables, day of flushing, and hormonal treatments (estradiol benzoate and progesterone) were determined for the reproductive measures using the Chi-square and Kruskal-Wallis tests. Significant effects were noted of the year, season and temperature on ERR (P < 0.05), but no significant effects were observed of the environmental parameters (year, season, hormone treatment, rainfall and photoperiod) on PR (P > 0.05). The day of uterine flush affected ERR (P < 0.05) but did not affect PR (P > 0.05). In addition, hormone treatment also supported favorable results of PR in recipient mares during nBS. The conclusion is that mares of this breed can be used in reproduction all year long, with good pregnancy rates, in Brazil's tropical environment. The hormone treatment also supported favorable pregnancy rates in recipient mares during the non-breeding season. It seems that mares can have good pregnancy rates throughout the year in Brazil´s tropical environment.

First record of in vitro formation of ectomycorrhizae in Psidium cattleianum Sabine, a native Myrtaceae of the Brazilian Atlantic Forest.

Like many other species of trees native to the Brazilian Mata Atlântica (Atlantic Forest), the Myrtaceae, such as the Red Araza (Psidium cattleianum Sabine), are widely cited as arbuscular mycorrhizal formers. Nevertheless, recent studies show evidence that Myrtaceae from different tropical, subtropical and neotropical ecosystems can also prompt the formation of ectomycorrhizae, indicating that this species' ectomycorrhizal status should be further explored. Because of this, this research effort studied the in vitro interaction between the Red Araza and two ectomycorrhizal fungi isolates, belonging to the Pisolithus microcarpus (D17) and Scleroderma citrinum (UFSC-Sc133) species. An analysis was performed to determine the formation of ectomycorrhizal structures, or lack thereof, and the developmental differences between the in vitro mycorrhized and non-mycorrhized plants. The analysis proved that indeed an ectomycorrhizal association was developed between the Red Araza, and the D17 and UFSC-Sc133 isolates, a fact never before registered in the existing literature. After an in vitro period of 110 days, it was confirmed that the D17 and UFSC-Sc133 isolates formed mycorrhizal colonization of 91.6% and 15.7%, respectively. Furthermore, both isolates also promoted root thickening, and the formation of a fungal mantle and a Hartig net. However, when compared to the Control plants, the fungal isolates did not contribute to an increase in the development of the subject plants, possibly due to the specific experimental conditions used, such as a high humidity environment and high availability of nutrients in the symbiotic substrate.

Structural and physiological responses of Halodule wrightii to ocean acidification.

Coastal areas face high variability of seawater pH. Ocean acidification (OA) and local stressors are enhancing this variability, which poses a threat to marine life. However, these organisms present potential phenotypic plasticity that can offer physiological and structural tools to survive in these extreme conditions. In this study, we evaluated the effects of elevated CO2 levels and consequent pH reduction on the physiology, anatomy and ultrastructure of the seagrass Halodule wrightii. A mesocosm study was conducted in an open system during a 30-day experiment, where different concentrations of CO2 were simulated following the natural variability observed in coastal reef systems. This resulted in four experimental conditions simulating the (i) environmental pH (control condition, without CO2 addition) and (ii) reduced pH by - 0.3 units, (iii) - 0.6 units and (iv) - 0.9 units, in relation to the field condition. The evaluated population only suffered reduced optimum quantum yield (Y(II)), leaf width and cross-section area under the lowest CO2 addition (- 0.3 pH units) after 30 days of experiment. This fitness commitment should be related to carbon concentration mechanisms present in the evaluated species. For the highest CO2 level, H. wrightii demonstrated a capacity to compensate any negative effect of the lowest pH. Our results suggest that the physiological behaviour of this primary producer is driven by the interactions among OA and environmental factors, like irradiance and nutrient availability. The observed behaviour highlights that high-frequency pH variability and multifactorial approaches should be applied, and when investigating the impact of OA, factors like irradiance, nutrient availability and temperature must be considered as well.

KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil.

The emergence of ß-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the bla KPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

Development of the SORRI-BAURU Posterior Walker.

This study aimed to report on the design and development of a low cost Reverse Walker through a participative development cycle with people undergoing rehabilitation. The creation and fundamentals of the concept are described, as well as the development of prototypes and their provision to subjects with mobility problems. The Reverse Walker benefits the user by promoting a more upright posture and favoring the development of postural balance. Enhancing the mobility of people with disabilities may benefit their independence, social participation and quality of life.

KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil

The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the blaKPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

Atenção ao aborto no Sistema Único de Saúde no Nordeste Brasileiro: a estrutura dos serviços / Abortion care in the Brazilian National Health Service in the Northeast of Brazil: the structure of services

Avaliar a estrutura de maternidades que prestam atenção a mulheres em situação de abortamento no Sistema Único de Saúde, em Salvador, Recife e São Luís. Métodos: foram selecionadas três maternidades em cada capital. Os dados foram obtidos por entrevista com gerente do serviço ou equipe de direção e observação direta. Utilizou-se instrumento com 120 questões pontuadas abrangendo seis componentes - planta física, recursos materiais, recursos humanos, materiais de consumo, educação em saúde e ferramentas de gestão que incorporam quatro dimensões de avaliação - insumo/ambiente físico; qualidade técnica e gerencial do cuidado; acolhimento/orientação e continuidade da atenção. Os resultados foram categorizados pelo percentual obtido em relação ao máximo esperado: suficiente (B a 80 por cento); intermediário (de 50 por cento a 79 por cento); insuficiente (< 50 por cento). Resultados: os componentes melhor pontuados foram planta física, recursos materiais e material de consumo. Educação em saúde e ferramentas de gestão tiveram pior pontuação. Nenhuma unidade atingiu nível considerado suficiente. Sete foram classificadas no nível intermediário e duas insuficiente. Conclusões: as unidades estudadas não apresentam estrutura adequada para o modelo de atenção ao abortamento preconizado. Há necessidade de intervenções para qualificar a estrutura dos serviços para a atenção ao aborto e promover a huma-nização do cuidado...

To assess the structure of maternity hospitals that provide care for woman undergoing abortions in the Brazilian National Health Service in the cities of Salvador, Recife and São Luís. Methods: three maternity hospitals were selected in each State capital. The data were obtained by way of interviews with the service manager or team of directors and direct observation. The interviews involved 120 questions divided into six sections - physical infrastructure, material resources, human resources, consumable materials, health education and management tools, covering four areas of evaluation - materials/physical environment; technical quality and care management; reception/guidance and continuity of care. The results were presented as a percentage of the maximum possible score: adequate (B80 percent); average (50 percent - 79 percent); inadequate (< 50 percent). Results: the highest scoring sections were physical infrastructure, material resources and consumable materials. Health education and management tools received the worst scores. No unit was deemed to have attained an adequate level of care. Seven were classified as average and two as inadequate. Conclusions: the units studied did not have an adequate structure for the intended abortion care model. There is a need for intervention to improve the structure of abortion care services and to promote the humanization of care...

Avaliação do estado nutricional e de saúde de crianças e adolescentes do município de Belmiro Braga (MG) / Assessment of nutritional status and health of children and adolescents in the city of Belmiro Braga (MG)

Objetivou neste estudo avaliar o perfil nutricional e as condições de saúde dos escolares, de maneira a identificar os grupos mais susceptíveis ao sobrepeso e à desnutrição, além da presença de parasitose causada por helmintos e/ou protozoários. Participaram do estudo 338 crianças, com idade entre 3 e 15 anos de idade, de ambos os sexos, matriculadas em 9 escolas do município de Belmiro Braga (MG). As variáveis antropométricas analisadas foram peso e estatura; um questionário socioeconômico foi aplicado para analisar as condições de moradia da família, além de constatar aspectos que possam influenciar o estado nutricional do indivíduo, como baixo peso ao nascer. Os escolares também foram submetidos a exame parasitológico de fezes. Para a obtenção da variável peso e estatura foi utilizada balança digital eletrônica portátil e estadiômetro portátil respectivamente. Todos os procedimentos foram realizados conforme protocolo já normatizado pela OMS. Os resultados indicaram que 1,2% dos escolares apresentavam IMC baixo para idade, 57,7% estavam eutróficos, 13,3% com sobrepeso, 5,6% obesos e 22,2% não foram avaliados devido à ausência de dados. Dentre os avaliados, 64,79% realizaram exame de fezes, dentre estes, a prevalência de parasitose acometeu 18,25%. Não encontramos associação entre a ausência de rede de esgoto, água encanada e coleta de lixo com a presença de protozoários e helmintos nas fezes. Assim como associação entre IMC e peso ao nascer. O estudo apresentado evidencia a importância da educação nutricional e higiênico-sanitária de maneira contínua aos escolares e manipuladores de alimentos.

Precisão dimensional de moldes de hidrocoloide irreversível manipulado com solução de clorexidina / Dimensional accuracy of irreversible hydrocolloid impressions manipulated with chlorhexidine solution

Objetivo: avaliar a precisão dimensional de modelos de gesso obtidos em moldes de hidrocoloide irreversível contendo agente antimicrobiano, manipulado com água ou solução aquosa de digluconato de clorexidina 0,2%. Materiais e método: para as medições das dimensões lineares, foram utilizados moldes de hidrocoloide irreversível de um modelo mestre de aço inox, simulando preparos de uma prótese fixa com dois pilares separados por um espaço protético. Com esses moldes, obteve-se vinte modelos de gesso designados aos grupos: controle - modelos de gesso obtidos em moldes de hidrocoloide irreversível contendo clorexidina no pó manipulado com água destilada (n = 10); experimental - modelos de gesso obtidos em moldes de hidrocoloide irreversível contendo clorexidina no pó e manipulado com solução de clorexidina em substituição à água (n = 10). As distâncias entre pilares e os diâmetros dos pilares foram mensuradas com paquímetro digital e os dados, submetidos ao teste t student. Resultado: as medições das distâncias entre pilares e do diâmetro dos pilares dos modelos do grupo experimental não resultaram em diferenças dimensionais estatisticamente significantes quando comparadas com as do grupo controle (p > 0,05). Conclusão: de acordo com os resultados deste estudo e considerando as suas limitações, pôde-se concluir que as diferenças dimensionais entre modelos de gesso obtidos com moldes de hidrocoloide irreversível manipulado com água ou com solução aquosa de digluconato de clorexidina a 0,2% não foram estatisticamente significantes.

Objective: to assess the dimensional accuracy of plaster casts obtained from irreversible hydrocolloid impressions containing anti-microbial agent, which was mixed with either water or 0.2% chlorhexidine digluconate aqueous solution. Materials and method: the linear dimensions were measured with irreversible hydrocolloid impressions of a stainless steel master cast simulating cavity preparations for a fixed prosthesis with two abutments separated by a prosthetic space. From these molds, twenty plaster casts were made and assigned to the following groups: control - plaster casts obtained from irreversible hydrocolloid impressions made with powder containing chlorhexidine, and manipulated with distilled water (n = 10); experimental - plaster casts obtained from irreversible hydrocolloid impressions made with powder containing chlorhexidine, and manipulated with chlorhexidine solution instead of water (n = 10). The distances between the abutments and their diameters were measured with a digital caliper and data were submitted to the Student's t test. Result: there were no statistically significant differences in the measurements of distances between the abutments and their diameter in the experimental group when compared to the measurements of the control group (p > 0.05). Conclusion: according to the results of this study and considering its limitations, the dimensional differences between plaster casts obtained from irreversible hydrocolloid impressions manipulated with either water or 0.2% chlorhexidine digluconate were not statistically different.

Instrumentos de avaliação funcional da mão: uma análise crítica de cinco testes / Functional hand assessment instruments: a critical analysis of five tests

A mão é parte essencial do corpo humano. Graças às funções, é um instrumento de ação indispensável para conseguirmos nossa independência e satisfazer nossas necessidades básicas. Entre essas funções, devemos destacar a sensorial e a motora, bem como a realização dos movimentos de pinça de precisão e de preensão. A perda de qualquer uma dessas funções da mão resulta em déficits desse processo. No Instituto Lauro de Souza Lima, o setor de Terapia Ocupacional atende pacientes procedentes do Setor Social, das enfermarias, dos ambulatórios de dermatologia e do setor de reabilitação pela ortopedia e fisiatria com diferentes patologias associadas a lesões nervosas periféricas, entre as quais, a principal é a Hanseníase. No setor de Terapia Ocupacional há um protocolo de monitoração neural que auxilia na prevenção de incapacidades norteando condutas da equipe de reabilitação entre osmédicos e os terapeutas, mas não há, de fato, um protocolo validado que guie a equipe para os pacientes em reabilitação cirúrgica. Devido a essa observação, houve a necessidade de inserir um instrumento de avaliação funcional da mão quantitativo, padronizado internacionalmente e validado no Brasil, para aplicação na rotina dos atendimentos pré e pós-operatório. O objetivo dessa pesquisa é, dentre cinco testes previamente escolhidos, identificar o que melhor preencha os requisitos necessários para implantação na rotina de atendimentos do setor de Terapia Ocupacional do instituto. A monografia foi constituída de uma análise bibliográfica baseada em dados colhidos em acervos nacionais e internacionais da área de saúde e em bases online da literatura científica. Foram analisadas as condições de aplicação, o realizar das atividades, a confiabilidade, a validade, a facilidade do teste, o tempo de aplicação e o custo do produto, para resultar, assim, em uma pesquisa qualificada e analítica para aplicação na rotina do setor.

The hand is an essential part of the human body. Thanks to functions, it is an indispensable instrument of action in order to get our independence and meet our basic needs. Among these functions, we must highlight the sensory and motor as well as the achievement of precision tweezers movements and hold. The loss of any of these functions hand deficits results in this process. The Institute Lauro de Souza Lima, the Occupational Therapy sector serves patients from the Social Sector, the wards, the dermatology clinics and rehabilitation sector for orthopedics and physiatry with different pathologies associated with peripheral nerve injuries, including the main It is leprosy. In occupational therapy industry for a neural monitoring protocol that helps prevent disabilities guiding rehabilitation team conducts between osmédicos and therapists, but there is, in fact, a validated protocol to guide the team to patients in surgical rehabilitation. Because of this observation, it was necessary to insert a functional assessment tool of quantitative hand, internationally standardized and validated in Brazil for application in routine pre and postoperative care. The purpose of this research is among five tests previously chosen, identify the one that best fulfills the requirements for deployment in routine care of Occupational Therapy Industry Institute. The paper consisted of a literature analysis based on data collected from national and international collections healthcare and online databases of scientific literature. The conditions of application were analyzed, the conduct of activities, reliability, validity, ease of testing, the application time and the cost of the product to result thus in a qualified and analytical research for investment in the sector routine