RESUMOObjetivo: Caracterizar o perfil populacional dos pacientes disártricos atendidos em um hospital terciário e apresentar as alterações mais frequentes nas cinco bases motoras que estão comumente alteradas nas disartrias. Métodos: Este estudo foi realizado por meio da análise da aplicação de um protocolo de disartria, composto por tarefas que avaliam a respiração, a fonação, a ressonância, a articulação e a prosódia. Foram escolhidos aleatoriamente 60 protocolos de disartria, que foram aplicados aos pacientes submetidos à avaliação, no ambulatório de Distúrbios da Comunicação do Hospital São Paulo -Hospital Escola da Universidade Federal de São Paulo -Escola Paulista de Medicina. A análise dos dados foi realizada de maneira descritiva. Resultados: Em relação ao perfil populacional dos pacientes disártricos atendidos em um hospital terciário, observamos prevalência do sexo masculino, acometidos principalmente entre 20 e 50 anos de idade. Os tipos mais comuns de disartria foram a flácida e a disartria do neurônio motor superior unilateral. A etiologia mais prevalente para este distúrbio de fala foi o AVC. Em relação às bases motoras avaliadas, houve predomínio de respiração do tipo mista, a rouquidão foi a característica vocal mais encontrada; o movimento velar esteve predominantemente adequado, apesar da identificação de hipernasalidade discreta. A articulação mostrou-se bastante comprometida nos quadros avaliados e houve predomínio de alteração discreta da prosódia na população investigada. Conclusão: Foi possível estabelecer o perfil de pacientes disártricos atendidos em Hospital terciário em nosso meio, que apresentaram predominantemente as seguintes características: ciclos respiratórios curtos, voz rouca, hipernasal, alteração moderada a grave de articulação, discreta alteração de prosódia e velocidade lenta de fala.Descritores: Disartria; Distúrbios da voz; Acústica da fala; Fala; Qualidade da voz INTRODUÇÃOA disartria é um distúrbio de fala, resultante de alterações no controle muscular dos mecanismos envolvidos em sua produção, originado por uma lesão do Sistema Nervoso Central ou Periférico que acarreta em alterações na emissão oral, devido a uma paralisia, fraqueza ou falta de coordenação dos músculos da fala (1) . Uma disartria pode ser secundária a uma tumoração do cérebro, cerebelo ou tronco encefálico, a doenças infecciosas, metabólicas, tóxicas ou degenerativas do sistema nervoso ou do sistema muscular. Geralmente, é uma sequela comum de lesões cerebrais não progressivas, consequentes de uma lesão vascular cerebral ou de uma traumatismo cranioencefálico, bem como de doenças progressivas neuromusculares ou que atingem o Sistema Extrapiramidal (2)(3)(4)(5) . Existem vários tipos de disartria, de acordo com o local da lesão: disartria flácida, disartria espástica, disartria do neurô-nio motor superior unilateral, disartria hipocinética, disartria hipercinética, disartria atáxica e disartria mista (4) . Cada um desses tipos apresenta características peculiares que envolvem o desempenho anormal das es...
The generation of inferences makes the construction and comprehension of discourse easier, and integrates representations which add coherence to the arguments. Visuoperceptual and inferential deficits merge in the attempt to explain the difficulties that some individuals have in the comprehension of certain kinds of visual stimuli.Objectivesa) To examine the performance of cognitively healthy elderly subjects in the execution of visual inferences using pictures of different levels of complexity;b) To compare the performance of subjects according to schooling level.MethodsA total of 45 normal elderly aged from 61 to 82yrs (M=68; SD=0.57) were examined. The subjects were divided into three groups according to schooling level: Group 1 (1 to 4 years); Group 2 (5 to 8 years) and Group 3 (9 or more years). Each subject had to create a narrative based on four figures with controlled visual complexity. The narratives were transcribed, analysed and scored.ResultsFor the essential inferences, the high educated group (3) had a better performance in both visually simple and complex conditions. On the visually complex figures, the medium educated group (2) was statistically equivalent to the high educated group for one figure and equivalent to the less educated group (1) for the other. There was no difference among the groups for the accessory propositions.ConclusionsVisual complexity interferes with the subject’s ability to make inferences in low and medium educated individuals. High educated subjects maintain the same performance in making inferences, regardless of the visual complexity level.
Inferences are mental representations derived from the interaction between explicit linguistic information and an individual's world knowledge. The right hemisphere (RH) is the main region responsible for this ability, particularly with regard to pictorial stimuli. The aims of this study were to evaluate the performance of RH-damaged patients on an inference comprehension task based on pictorial stimuli and to compare the effect of different lesion sites on this performance. We compared the inferential abilities of 75 healthy controls and 50 patients with RH damage of vascular origin using 13 pictorial stimuli from the instrument "300 Exercises of Comprehension of Logical and Pragmatic Inferences and Causal Chains." RH-damaged patients performed worse than controls in comprehending logical and pragmatic visual inferences independent of lesion site (p < .0001). The subgroup with posterior lesions performed worse than the other subgroups.
Working memory is a system with a limited capacity which enables the temporary storage and manipulation of the information necessary for complex cognitive tasks. Numerous studies have suggested that performance in these tasks is related to age where older adults have a lesser performance than the young.ObjectiveTo analyze the processing functions of working memory in a listening task.Method59 educated participants aged between 19 and 76 years having no memory complaints were divided into two groups (young and aged adults). The test administered was the adapted Listening Span, in which the subject listens to a sentence, judging whether it is true or false and, concomitantly, stores the last word of each sentence for later evocation.ResultsIn the judgment task, performance of both groups approached to a similar average. Results of sentence recall demonstrated that with the increase in number of sentences at each level, performance of both groups declined. In the blocks of sentences 1 and 2 at level 1, all participants performed similarly. In the block of sentences 3, at level 1, there was a difference between the young and the aged. From this level onward (retention of 3 to 5 items), the aged and the young differed significantly.ConclusionsAn increase in the number of sentences diminished participants’ performance of temporary storage in the recall tasks, while not interfering in the processing of sentences during judgment. The difference between the young and the aged became more accentuated as item retention demands increased.
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