Hypothyroidism and acute kidney injury: An unusual association

Association between severe hypothyroidism and acute kidney injury (AKI) is rare. A 40-year-old woman presented with 15 days history of generalised muscle pain, weakness, weight gain and oedema. Medical history: hypertension and hypothyroidism. Physical examination: dry skin, peripheral/periorbital oedema, slow thought and speaking, thyroid increased. Laboratory examinations: high levels of creatine kinase , creatinine, uric acid and lactate dehydrogenase. Free T4 was very low (<0.3 ng/dL) and thyroid-stimulating hormone was high (21.7 mIU/mL). Urinalysis showed haem pigment without haematuria. We performed the diagnosis of AKI secondary to hypothyroidism-induced rhabdomyolysis. Intravenous fluids were started, urinary alkalisation and increased l-thyroxine dose replacement. On the day after admission, forced diuresis with furosemide was introduced leading to a progressive improvement of symptoms. Although hypothyroidism and AKI is unusual, it should be suspected in patients presenting decrease of renal function and high creatine kinase in the absence of other causes of rhabdomyolysis.

Reconhecimento de palavras, nomeação de figuras e de palavras impressas em surdos implantados pré-linguais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A motivação na aprendizagem de língua estrangeira via teletandem

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A oralidade nos cursos a distância de licenciatura em Letras com habilitação em língua portuguesa: uma análise discursiva

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Capacitacitação de professores no contexto de sistemas de comunicação suplementar e alternativa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da proficiência oral em inglês como língua estrangeira: foco na competência lexical e uma proposta para o processo de validação do descritor vocabulário de um teste de proficiência para professores de língua inglesa

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relação entre potenciais evocados auditivos de média latência e distúrbio de processamento auditivo: estudo de casos

The Auditory Evoked Middle Latency Response is one of the most promising objective tests in audiology and in revealing brain dysfunction and neuro-audiologic findings. The main advantages of its clinical use are precision and objectivity in evaluating children. This study aimed to analyze the auditory evoked middle latency response in two patients with auditory processing disorder and relate objective and behavioral measures. This case study was conducted in 2 patients (P1 = 12 years, female, P2 = 17 years old, male), both with the absence of sensory abnormalities, neurological and neuropsychiatric disorders. Both were submitted to anamnesis, inspection of the external ear canal, hearing test and evaluation of Auditory Evoked Middle latency Response. There was a significant association between behavioral test and objectives results. In the interview, there were complaints about the difficulty in listening in a noisy environment, sound localization, inattention, and phonological changes in writing and speaking, as confirmed by evaluation of auditory processing and Auditory Evoked Middle Latency Response. Changes were observed in the right decoding process hearing in both cases on the behavioral assessment of auditory processing; auditory evoked potential test middle latency shows that the right contralateral via response was deficient, confirming the difficulties of the patients in the assignment of meaning in acoustic information in a competitive sound condition at right, in both cases. In these cases it was shown the association between the results, but there is a need for further studies with larger sample population to confirm the data.

Ecóico e nomeação de figuras em crianças com deficiência auditiva pré-lingual com implante coclear

The aim of this work was to verify the effect of teaching the echoic behavior over the pictures naming in four children between eight and nine years old with prelingual hearing impaired, users of cochlear implants. The design adopted was: (a) pre-training that taught the matching-to-sample task; (b) pre-tests that selected three words to teach; (c) teaching of auditory-visual conditional relations; (d) naming pos-test; (e) the teaching of echoic with orofacial clues and, (f) the second naming pos-test. In the pre-test all participants achieved smaller percentage of correct on naming (60%-80%) and echoic (20%-50%) when compared to percentages word recognition (86%-93%). All participants learned the auditory-visual relations. The improvement on naming test occurred after auditory training select based for two participants; for other two participants the improvement on naming test occurred just after the training of echoic. Analysis of data showed that the listening and speaking performances are independent in their establishment and require specific conditions of teaching; in the case of this study, even though the result is not generalized to all participants, the highest correspondence into point to point naming was obtained following the teaching of echoic.

Effect of denture fabrication and wear on closest speaking space and interocclusal distance during deglutition

Statement of problem. The accuracy of assessing maxillomandibular relationships for trial bases and dentures using phonetic and swallowing methods has not been compared to that observed with definitive prostheses. Thus, there is no evidence to prove whether measurements obtained through such methods remain the same after adaptation to dentures.Purpose. This study investigated changes in the closest speaking space, interocclusal rest space, and interocclusal distance during deglutition in edentulous patients during and after complete denture treatment.Material and methods. Eighteen edentulous subjects participated in this study and measurements were performed after 7 Intervals of time: (1) with occlusion rims and record bases following creation of the maxillomandibular relationship record, (2) with trial dentures, (3) at Insertion of definitive complete dentures, (4) 1 week, (5) 2 weeks, (6) 1 month, and (7) 3 months after insertion. Recordings of interocclusal distances were made with a mandibular kinesiograph. Closest speaking space was measured during the pronunciation of the word 'seis'. The distance between postural rest position and centric occlusion, or interocclusal rest space, was measured using a kinesiograph. Interocclusal distance during deglutition was tested by recording the closest mandibular position recorded during swallowing of 20 mL of water. Data were analyzed using repeated-measure ANOVA, followed by the Student-Newman-Keuls test (alpha=.05).Results. A significant (P <.01)reduction in the mean closest speaking space was found when it was evaluated using occlusion rims and record bases (4.6 mm) compared with other stages (3.0 to 3.4 mm). No significant differences were found in mean interocclusal rest space and interocclusal distance during deglutition among the time periods evaluated.Conclusions. The presence of occlusion rims can influence mandibular position during pronunciation of the /s/ sound. The arrangement of artificial teeth changes the closest speaking space. However, rest position and deglutition were not affected, either during denture fabrication or short-term use.

Relation between speaking space of the /s/ sound and freeway space in dentate and edentate subjects.

The purpose of this study is to assess the relation between the speaking space of the /s/ sound and the freeway space in two subject groups. One group had natural dentition (Group I, n = 61) and the other comprised complete denture wearers (Group II, n = 33). The analysis was done by means of a jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, USA). Freeway space was determined by asking the subjects to occlude from the postural rest position. Speaking space of /s/ was measured during the pronunciation of the word seis and comprised the mean distance from the /s/ speaking position to maximal intercuspation. A weak correlation was found between the speaking space of /s/ and the freeway space in Group I (r = 0.41, p < 0.01), but in Group II, the correlation was stronger (r = 0.75, p < 0.01). The speaking space of /s/ and freeway space were different in Group I, but statistically similar in Group II (paired t-test, alpha = 0.05). It can be suggested that anatomic changes following prosthetic procedures caused a functional adaptation which resulted in more similar values for the speaking space of /s/ and the freeway space.

Comments about some species abundance patterns: classic, neutral, and niche partitioning models

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

GRAMMAR and COMMUNICATION IN PORTUGUESE AS A FOREIGN LANGUAGE A Study in the Context of Teletandem Interactions

This paper presents a study about the role of grammar in on-line interactions conducted in Portuguese and in English, between Brazilian and English-speaking interactants, with the aim of teaching Portuguese as a foreign language (PFL). The interactions occurred by means of chat and the MSN Messenger, and generated audio and video data for language analysis. Grammar is dealt with from two perspectives, an inductive and a deductive approach, so as to investigate the relevance of systematization of grammar rules in the process of learning PFL in teletandem interactions.

Errors in nonword repetition: bridging short- and long-term memory

According to the working memory model, the phonological loop is the component of working memory specialized in processing and manipulating limited amounts of speech-based information. The Children's Test of Nonword Repetition (CNRep) is a suitable measure of phonological short-term memory for English-speaking children, which was validated by the Brazilian Children's Test of Pseudoword Repetition (BCPR) as a Portuguese-language version. The objectives of the present study were: i) to investigate developmental aspects of the phonological memory processing by error analysis in the nonword repetition task, and ii) to examine phoneme (substitution, omission and addition) and order (migration) errors made in the BCPR by 180 normal Brazilian children of both sexes aged 4-10, from preschool to 4th grade. The dominant error was substitution [F(3,525) = 180.47; P < 0.0001]. The performance was age-related [F(4,175) = 14.53; P < 0.0001]. The length effect, i.e., more errors in long than in short items, was observed [F(3,519) = 108.36; P < 0.0001]. In 5-syllable pseudowords, errors occurred mainly in the middle of the stimuli, before the syllabic stress [F(4,16) = 6.03; P = 0.003]; substitutions appeared more at the end of the stimuli, after the stress [F(12,48) = 2.27; P = 0.02]. In conclusion, the BCPR error analysis supports the idea that phonological loop capacity is relatively constant during development, although school learning increases the efficiency of this system. Moreover, there are indications that long-term memory contributes to holding memory trace. The findings were discussed in terms of distinctiveness, clustering and redintegration hypotheses.

Trilled sounds in Brazilian Portuguese: Phonetic and phonological characterization

This paper deals with the phonological definition of trills in Brazilian Portuguese. The phonemic existence of two distinctive R's, one soft the other strong, is taken for granted. After reviewing the ideas of some Portuguese-speaking phoneticians on this matter, 146 occurrences of R's - recorded by two informants - were acoustically analyzed, the formants' general aspect and the length of the R segments were studied in the resulting spectrograms. The phonological table displayed in the conclusion does not include any trill. The soft phoneme /r/, instead, is classified as an interrupted apico-alveolar tap with a retroflex allophone. Naturalization between these two units is discarded.t

Role of 5-HT in stress, anxiety, and depression

There are conflicting results on the function of 5-HT in anxiety and depression. To reconcile this evidence, Deakin and Graeff have suggested that the ascending 5-HT pathway that originates in the dorsal raphe nucleus (DRN) and innervates the amygdala and frontal cortex facilitates conditioned fear, while the DRN-periventricular pathway innervating the periventricular and periaqueductal gray matter inhibits inborn fight/flight reactions to impending danger, pain, or asphyxia. To study the role of the DRN 5-HT system in anxiety, we microinjected 8-OH-DPAT into the DRN to inhibit 5 HT release. This treatment impaired inhibitory avoidance (conditioned fear) without affecting one-way escape (unconditioned fear) in the elevated T-maze, a new animal model of anxiety. We also applied three drug treatments that increase 5-HT release from DRN terminals: 1) intra-DRN microinjection of the benzodiazepine inverse agonist FG 4172, 2) intra-DRN microinjection of the excitatory amino acid kainic acid, and 3) intraperitoneal injection of the 5-HT releaser and uptake blocker D-fenfluramine. All treatments enhanced inhibitory avoidance in the T-maze. D-Fenfluramine and intra-DRN kainate also decreased one-way escape. In healthy volunteers, D-fenfluramine and the 5-HT agonist mCPP (mainly 5-HT2C) increased, while the antagonists ritanserin (5-HT2A/(2C)) and SR 46349B (5-HT2A) decreased skin conductance responses to an aversively conditioned stimulus (tone). In addition, D-fenfluramine decreased, whereas ritanserin increased subjective anxiety induced by simulated public speaking, thought to represent unconditioned anxiety. Overall, these results are compatible with the above hypothesis. Deakin and Graeff have suggested that the pathway connecting the median raphe nucleus (MRN) to the dorsal hippocampus promotes resistance to chronic, unavoidable stress. In the present study, we found that 24 h after electrolytic lesion of the rat MRN glandular gastric ulcers occurred, and the immune response to the mitogen concanavalin A was depressed. Seven days after the same lesion, the ulcerogenic effect of restraint was enhanced. Microinjection of 8-OH-DPAT, the nonselective agonist 5-MeO-DMT, or the 5-HT uptake inhibitor zimelidine into the dorsal hippocampus immediately after 2 h of restraint reversed the deficits of open arm exploration in the elevated plus-maze, measured 24 h after restraint. The effect of the two last drugs was antagonized by WAY-100135, a selective 5-HT1A receptor antagonist. These results are compatible with the hypothesis that the MRN-dorsal hippocampus 5-HT system attenuates stress by facilitation of hippocampal 5-HT1A-mediated neurotransmission. Clinical implications of these results are discussed, especially with regard to panic disorder and depression.