A retextualização como prática nas terapias fonoaudiológicas com sujeitos surdos / Retextualization as a practice in speech language therapy with deaf individuals

Para que sujeitos surdos estabeleçam relações entre a língua brasileira de sinais e a língua portuguesa, o uso de recursos de retextualização pode ser uma ferramenta capaz de levar tais sujeitos a produzirem gêneros textuais escritos de acordo com convenções ortográficas e gramaticais do português. Nesta perspectiva, o objetivo deste trabalho é discutir o processo de retextualização usado como prática nas terapias fonoaudiológicas em grupo como um meio desses sujeitos se apropriarem da língua portuguesa em sua modalidade escrita. Participaram da pesquisa 8 surdos que fazem uso de Libras e da língua portuguesa em sua modalidade escrita. Inicialmente, os sujeitos produziam textos em língua de sinais que, depois de comentados e discutidos, em sessões em grupo, contando com a presença de uma fonoaudióloga, além de outros profissionais, eram retextualizados por meio da escrita. Após a retextualização, os sujeitos surdos foram convocados a reler o texto e, caso julgassem necessário, a modificá-lo. Na sequência, eles reliam os textos em conjunto com os profissionais e o retextualizavam em uma versão final escrita. Nos textos analisados, as operações de reestruturações sintáticas, de reconstruções textuais em função da norma da língua, bem como as de tratamento estilístico com seleção de novas estruturas sintáticas e opções lexicais foram as mais usadas nos processos de retextualização. A partir dos processos de retextualização, os surdos passaram a refletir sobre a escrita e sua função social, assumindo essa modalidade da linguagem com mais disposição e autoconfiança.

The use of retextualization resources is a helpful way to let deaf individuals to produce textual writing gender according to orthographic and grammatical Portuguese conventions. In this way, this work aims to discuss the retextualization processes used as a practice in speech language therapy group sessions as a way for this population to make use of writing Portuguese language. In this research there are writing samples wrote by 8 deaf individuals that use sign language and writing Portuguese language. These papers were produced in group sessions, with deaf individuals, a speech language therapist and other professionals. The deaf individuals at first produced the samples in sign language, after that, they commented and discussed and afterwards the samples were retextualized through writing language. After the retextualization, deaf individuals were asked to read the texts and if it was necessary modify it. Following that, the deaf individuals and the professionals read the text again and retextualizes it in a final writing version. In the analyzed texts the retextualization operations used with more frequency were: syntactic rebuilds, rebuilt some structures to make the sentences inside the language rules, and stylistics treatment selecting new syntactic and lexical structures Through retextualization processes, deaf individuals start to consider Portuguese writing language and its social function, using this modality of language with more disposition and confidence.

Ataxia espinocerebelar tipo 6: relato de caso / Spinocerebellar ataxia type 6: a case report

O objetivo deste estudo foi verificar as alterações vestibulococleares observadas em um caso de ataxia espinocerebelar tipo 6. O caso foi encaminhado do Hospital de Clínicas para o Laboratório de Otoneurologia de uma Instituição de Ensino e foi submetido aos seguintes procedimentos: anamnese, inspeção otológica, avaliações audiológica e vestibular. O caso retrata uma paciente com diagnóstico genético de ataxia espinocerebelar tipo 6, do sexo feminino, com 57 anos de idade, que referiu desequilíbrio à marcha com tendência a queda para a esquerda, disartria e disfonia. Na avaliação audiológica apresentou configuração audiométrica descendente a partir da frequência de 4kHz e curva timpanométrica do tipo "A" com presença dos reflexos estapedianos bilateralmente. No exame vestibular observou-se na pesquisa da vertigem posicional presença de nistagmo vertical inferior e oblíquo, espontâneo e semiespontâneo múltiplo com características centrais (ausência de latência, paroxismo, fatigabilidade e vertigem), nistagmooptocinético abolido e hiporreflexia à prova calórica. Constataram-se alterações labirínticas que indicaram afecção do sistema vestibular central evidenciando-se a importância dessa avaliação. A existência da possível relação entre os achados com os sintomas vestibulares apresentados pela paciente apontou a relevância do exame labiríntico neste tipo de ataxia uma vez que a presença do nistagmo vertical inferior demonstrou ser frequente neste tipo de patologia.

The aim of this study was to investigate the vestibulocochlear alterations observed in a case of spinocerebellar ataxia type 6. The case was referred from the Hospital das Clinicas to the Otoneurology Laboratory of an educational institution and was subjected to the following procedures: anamnesis, otologic examination, as well as audiological and vestibular assessments. The case shows a 57-year-old female patient with a genetic diagnosis of spinocerebellar ataxia type 6 who presented unsteadiness of gait with tendency to fall to the left, dysarthria, and dysphonia. The audiological assessment presented sloping audiometric configuration from 4.0 kHz and tympanogram type “A” with the presence of acoustic reflexes bilaterally. Observed during the survey of positional vertigo in the vestibular assessment were the presence of oblique and vertical downbeat nystagmus, spontaneous and semispontaneous with multiple core features (absence of latency, paroxysm, fatigue and vertigo), abolished optokineticnystagmus and hyporeflexia in the caloric test. We found labyrinthic alterations that indicate central vestibular system disorders and lend credence to the importance of this evaluation. The existence of a possible relationship between the findings and vestibular symptoms displayed by the patient indicated the relevance of the labyrinthine evaluation for this type of ataxia once the presence of vertical downbeat nystagmus proved to be frequent in this type of pathology.

Vestibular dysfunction in adolescents and young adults after kidney transplant.

INTRODUCTION: Chronic kidney disease is a slowly progressive disease that causes irreversible loss of renal function and is considered a public health problem worldwide. OBJECTIVE: To evaluate the vestibular behavior in patients with chronic kidney disease undergoing renal transplantation. METHODS: A retrospective cross-sectional study was performed. Thirty patients were evaluated, 33.3% female and 66.7% male (mean age 16.9 (± 3.6) years old). Patients underwent the following procedures: anamnesis, ENT (ear, nose, and throat) evaluation and vestibular evaluation. RESULTS: The patients reported dizziness when they were on dialysis. 50% the patients showed an abnormality in the vestibular test, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system and there was a predominance of deficit peripheral vestibular disorders. CONCLUSION: The dizziness was the most significant symptom for the vestibular test in correlation with neurotological symptoms. Alteration in the vestibular exam occurred in the caloric test, there was a prevalence of alterations for the peripheral vestibular system with a predominance of deficit vestibular dysfunction. We emphasize the need to show professionals involved in patients with chronic kidney disease, those undergoing renal transplant and dialitic treatment the importance of prevention and early identification of otoneurological involvement.

Vestibular findings in autosomal recessive ataxia.

OBJECTIVE: This study aims to examine vestibular disorders in patients with recessive spinocerebellar ataxia. DESIGN: A retrospective cross-sectional study was conducted. The patients underwent the following procedures: case history, ENT and vestibular evaluations. STUDY SAMPLE: The tests were performed in 19 patients ranging from 6 to 63 years of age (mean age of 36.7). RESULTS: Clinically, the patients commonly had symptoms of dizziness (57.8%), lack of coordination of movement with imbalance when walking (52.6%), and headaches (42.1%). In vestibular testing, alterations were predominantly evident under caloric testing (73.5%), rotational chair testing, and testing for gaze and optokinetic nystagmus (36.8%). The presence of alterations occurred under examination in 89.5% of these patients, 100% occurred in subjects with Friedreich's ataxia and 84.6% for subjects with indeterminate recessive spinocerebellar ataxia, with the majority occurring in those with central vestibular dysfunction, 57.9% of the examinations. CONCLUSION: The most evident neurotological symptoms were dizziness, lack of coordination of movement, and imbalance when walking. Alterations in vestibular examinations occurred in 89.5% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction. This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases.