A Case of an Elderly Patient With Rubber Band Syndrome.

Rubber band syndrome is a relatively rare disease in which a rubber band around a limb becomes embedded under the skin, resulting in tissue damage. Most reported cases are in children, and its occurrence in adults is considered extremely rare. We present a case of a 71-year-old patient with cognitive impairment, in whom a rubber band around the wrist became embedded under the skin. The examination of the distinctive circumferential scar, ultrasonography, x-ray, and magnetic resonance imaging led to the diagnosis of rubber band syndrome. To avoid further damage to the tissue, surgical removal of the band was conducted. When elderly patients with cognitive impairment present with chief complaints of swelling and contracture in the limbs due to an unknown cause, accompanied by a circumferential scar on the affected limb, rubber band syndrome should be considered. Due to risk of deep tissue necrosis, prompt band removal is necessary.

Indicadores comunicativos, motores e cognitivos do desenvolvimento de crianças deficientes auditivas / Communicative indicators, motor and cognitive development of hearing-impaired children

INTRODUCTION: For the assessment of child development in the deaf is effective protocols are needed for this population, as in Brazil, standardized tests for these children are still scarce 4.5. Thus, emphasis is placed on studying child development in deaf so that therapeutic and educational approaches are contemplated in accordance with the needs of each child. OBJECTIVE: Analyze the performance of children with hearing deficit in different areas: Communications-Issue, Communication-reception, aspects Motors and Cognitive Aspects of Language. METHODS: We have carried out a comparative study in an institutional clinic with 109 children, divided into 60 hearing individuals with typical development and 49 with hearing loss, severe to profound. The performance index was calculated for each child in these four domains. The index was analysed according to the equation: (number of responses in each area / number of assessed behaviours) x100. RESULTS: In all age groups, hearing-impaired children had a smaller performance when compared to hearing children in the Communication - Emission domain. The Communication-Reception domain showed significant differences (p < 0.05) from the 12-to-23-months to the 60-to-71-months age groups. The Cognitive Aspects domain demonstrated a significant difference (p < 0.01) between hearing-impaired and hearing children aged 24 to 35 months and onwards. Motor Aspects only had a significant difference (p < 0.01) in the last two age groups, 48-59 months and 60-71 months. The significance level was 5%. CONCLUSION: In all age groups, hearing-impaired children's performance was worse when compared to hearing children. The intervention made by health professionals ought to take place as soon as possible in order to develop the cognitive, motor and language skills of the hearing-impaired child.

INTRODUÇÃO: Para que a avaliação do desenvolvimento infantil em deficientes auditivos seja efetiva são necessários protocolos para esta população, já que, no Brasil, testes padronizados para estas crianças ainda são escassos 4,5. Assim, dá-se ênfase em estudar o desenvolvimento infantil em deficientes auditivos, para que abordagens terapêuticas e educacionais sejam contempladas de acordo com a necessidade de cada criança. OBJETIVO: Analisar o desempenho de crianças com déficit de audição nos diferentes domínios: Comunicação-Emissão, Comunicação-Recepção, Aspectos Motores e Aspectos Cognitivos da Linguagem. MÉTODO: Estudo comparativo em uma clínica institucional com 109 crianças, divididas em 60 crianças ouvintes com desenvolvimento típico e 49 crianças com perda auditiva neurossensorial de grau severo a profundo bilateral, para verificação dos desempenhos nos domínios Comunicação - Emissão e Recepção, Aspectos motores e Aspectos Cognitivos da Linguagem. Para cada criança foi calculado o índice de desempenho na Comunicação - Emissão e Recepção, Aspectos Motores e Aspectos Cognitivos da Linguagem. Os índices foram analisados da seguinte forma: (número respostas presentes em cada domínio/número de comportamentos avaliados) x100. RESULTADOS: Em todas as faixas etárias, encontramos desempenho inferior de crianças deficientes auditivas quando comparadas às crianças ouvintes no domínio Comunicação-Emissão. O domínio Comunicação-Recepção apresentou diferenças significantes (p < 0,05) a partir da faixa etária de 12 a 23 meses até a faixa de 60 a 71 meses. O domínio Aspectos Cognitivos da Linguagem apresentou diferença significante (p<0,01) entre crianças deficientes auditivas e ouvintes da faixa etária de 24 a 35 meses em diante. No domínio Aspectos Motores foi observada diferença significante (p<0,01) apenas nas duas últimas faixas etárias de 48 a 59 meses e 60 a 71 meses. O nível de significância adotado foi de 5%. CONCLUSÕES: Em todas as faixas etárias, encontramos desempenho inferior de crianças deficientes auditivas quando comparadas às crianças ouvintes.

Use of nouns and verbs in the oral narrative of individuals with hearing impairment and normal hearing between 5 and 11 years of age.

CONTEXT AND OBJECTIVE: Nouns and verbs indicate actions in oral communication. However, hearing impairment can compromise the acquisition of oral language to such an extent that appropriate use of these can be challenging. The objective of this study was to compare the use of nouns and verbs in the oral narrative of hearing-impaired and hearing children. DESIGN AND SETTING: Analytical cross-sectional study at the Department of Speech-Language and Hearing Sciences, Universidade Federal de São Paulo. METHODS: Twenty-one children with moderate to profound bilateral neurosensory hearing impairment and twenty-one with normal hearing (controls) were matched according to sex, school year and school type. A board showing pictures was presented to each child, to elicit a narrative and measure their performance in producing nouns and verbs. RESULTS: Twenty-two (52.4%) of the subjects were males. The mean age was 8 years (standard deviation, SD = 1.5). Comparing averages between the groups of boys and girls, we did not find any significant difference in their use of nouns, but among verbs, there was a significant difference regarding use of the imperative (P = 0.041): more frequent among boys (mean = 2.91). There was no significant difference in the use of nouns and verbs between deaf children and hearers, in relation to school type. Regarding use of the indicative, there was a nearly significant trend (P = 0.058). CONCLUSION: Among oralized hearing-impaired children who underwent speech therapy, their performance regarding verbs and noun use was similar to that of their hearing counterparts.

Use of nouns and verbs in the oral narrative of individuals with hearing impairment and normal hearing between 5 and 11 years of age / Uso de substantivos e verbos na narrativa oral de deficientes auditivos e ouvintes entre 5 e 11 anos de idade

CONTEXT AND OBJECTIVE: Nouns and verbs indicate actions in oral communication. However, hearing impairment can compromise the acquisition of oral language to such an extent that appropriate use of these can be challenging. The objective of this study was to compare the use of nouns and verbs in the oral narrative of hearing-impaired and hearing children. DESIGN AND SETTING: Analytical cross-sectional study at the Department of Speech-Language and Hearing Sciences, Universidade Federal de São Paulo. METHODS: Twenty-one children with moderate to profound bilateral neurosensory hearing impairment and twenty-one with normal hearing (controls) were matched according to sex, school year and school type. A board showing pictures was presented to each child, to elicit a narrative and measure their performance in producing nouns and verbs. RESULTS: Twenty-two (52.4%) of the subjects were males. The mean age was 8 years (standard deviation, SD = 1.5). Comparing averages between the groups of boys and girls, we did not find any significant difference in their use of nouns, but among verbs, there was a significant difference regarding use of the imperative (P = 0.041): more frequent among boys (mean = 2.91). There was no significant difference in the use of nouns and verbs between deaf children and hearers, in relation to school type. Regarding use of the indicative, there was a nearly significant trend (P = 0.058). CONCLUSION: Among oralized hearing-impaired children who underwent speech therapy, their performance regarding verbs and noun use was similar to that of their hearing counterparts. .

CONTEXTO E OBJETIVO: Substantivos e verbos indicam ações na comunicação oral. Na ocorrência de perda auditiva, a aquisição da linguagem oral pode ser comprometida a tal ponto que o uso apropriado deles pode constituir importante desafio. O objetivo deste estudo é comparar o uso de substantivos e verbos na narrativa oral de deficientes auditivos e de ouvintes. TIPO DE ESTUDO E LOCAL: Estudo transversal analítico no Departamento de Fonoaudiologia, Universidade Federal de São Paulo. MÉTODOS: 21 crianças portadoras de deficiência auditiva neurossensorial de grau moderado a profundo bilateral e 21 crianças com audição normal (controles) pareadas por sexo, ano de escolaridade e tipo de escola. Uma prancha com figuras foi apresentada para cada criança para elicitar uma narrativa e medir o desempenho na produção de substantivos e verbos. RESULTADOS: 22 (52,4%) eram do sexo masculino. A idade média foi de 8 anos (desvio padrão, DP = 1,5). Ao comparar a média entre os grupos de meninos e meninas, não encontramos diferença significativa no uso de substantivos, porém entre os verbos, encontramos diferença significante no uso do imperativo (P = 0,041): mais frequente entre os meninos (média = 2,91). Não houve diferença significativa no uso de substantivos e verbos entre crianças surdas e ouvintes, em relação ao tipo de escola. No caso do uso do modo indicativo, houve uma tendência a diferença (P = 0,058). CONCLUSÕES: Crianças com deficiência auditiva oralizadas e submetidas à fonoterapia obtiveram desempenho semelhante a de seus pares ouvintes quanto ao uso de verbos e substantivos. .