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J Am Podiatr Med Assoc ; 109(6): 467-470, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31755774


Psoriatic arthritis is an uncommon, chronic inflammatory disease. Laboratory testing for psoriatic arthritis, although necessary for a complete work-up, is generally nondiagnostic for most patients. We present a case of a 26-year-old woman with unilateral plantar forefoot pain and swelling that was diagnosed as psoriatic arthritis. The diagnosis was made without the benefit of skin manifestations or definitive laboratory results, other than those from laboratory tests performed for an initial evaluation of acute-phase reactants. Radiographs showed nonspecific subchondral bone changes at a few metatarsophalangeal joints of the involved foot that suggested an inflammatory arthropathy. This case illustrates that the absence of specific serum markers for psoriatic arthritis can make its diagnosis challenging, especially in the absence of dermatologic changes of psoriasis.

Artrite Psoriásica/diagnóstico , Biomarcadores/análise , Ossos do Pé/diagnóstico por imagem , Adulto , Artrite Psoriásica/diagnóstico por imagem , Feminino , Humanos , Radiografia
Dev Sci ; 18(5): 751-70, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25440407


Previous studies indicate that at least some aspects of audiovisual speech perception are impaired in children with specific language impairment (SLI). However, whether audiovisual processing difficulties are also present in older children with a history of this disorder is unknown. By combining electrophysiological and behavioral measures, we examined perception of both audiovisually congruent and audiovisually incongruent speech in school-age children with a history of SLI (H-SLI), their typically developing (TD) peers, and adults. In the first experiment, all participants watched videos of a talker articulating syllables 'ba', 'da', and 'ga' under three conditions - audiovisual (AV), auditory only (A), and visual only (V). The amplitude of the N1 (but not of the P2) event-related component elicited in the AV condition was significantly reduced compared to the N1 amplitude measured from the sum of the A and V conditions in all groups of participants. Because N1 attenuation to AV speech is thought to index the degree to which facial movements predict the onset of the auditory signal, our findings suggest that this aspect of audiovisual speech perception is mature by mid-childhood and is normal in the H-SLI children. In the second experiment, participants watched videos of audivisually incongruent syllables created to elicit the so-called McGurk illusion (with an auditory 'pa' dubbed onto a visual articulation of 'ka', and the expectant perception being that of 'ta' if audiovisual integration took place). As a group, H-SLI children were significantly more likely than either TD children or adults to hear the McGurk syllable as 'pa' (in agreement with its auditory component) than as 'ka' (in agreement with its visual component), suggesting that susceptibility to the McGurk illusion is reduced in at least some children with a history of SLI. Taken together, the results of the two experiments argue against global audiovisual integration impairment in children with a history of SLI and suggest that, when present, audiovisual integration difficulties in this population likely stem from a later (non-sensory) stage of processing.

Percepção Auditiva/fisiologia , Potenciais Evocados/fisiologia , Transtornos da Linguagem/fisiopatologia , Percepção da Fala/fisiologia , Percepção Visual/fisiologia , Estimulação Acústica , Adolescente , Adulto , Criança , Eletroencefalografia , Feminino , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Estimulação Luminosa , Aprendizagem Verbal , Adulto Jovem
J Speech Lang Hear Res ; 57(4): 1480-502, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24686922


PURPOSE: The authors examined whether school-age children with a history of specific language impairment (H-SLI), their peers with typical development (TD), and adults differ in sensitivity to audiovisual temporal asynchrony and whether such difference stems from the sensory encoding of audiovisual information. METHOD: Fifteen H-SLI children, 15 TD children, and 15 adults judged whether a flashed explosion-shaped figure and a 2-kHz pure tone occurred simultaneously. The stimuli were presented at 0-, 100-, 200-, 300-, 400-, and 500-ms temporal offsets. This task was combined with EEG recordings. RESULTS: H-SLI children were profoundly less sensitive to temporal separations between auditory and visual modalities compared with their TD peers. Those H-SLI children who performed better at simultaneity judgment also had higher language aptitude. TD children were less accurate than adults, revealing a remarkably prolonged developmental course of the audiovisual temporal discrimination. Analysis of early event-related potential components suggested that poor sensory encoding was not a key factor in H-SLI children's reduced sensitivity to audiovisual asynchrony. CONCLUSIONS: Audiovisual temporal discrimination is impaired in H-SLI children and is still immature during mid-childhood in TD children. The present findings highlight the need for further evaluation of the role of atypical audiovisual processing in the development of SLI.

Percepção Auditiva , Potenciais Evocados/fisiologia , Transtornos do Desenvolvimento da Linguagem/psicologia , Percepção do Tempo , Percepção Visual , Estimulação Acústica/métodos , Adulto , Atenção , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos , Adulto Jovem