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Patient suitability for free water protocols in acute stroke and general medicine: a qualitative study of clinician perceptions
CONCLUSIONS & IMPLICATIONS: Despite the benefits of FWPs in other settings, in acute stroke and general medicine, clinicians erred on the side of safety and, in most cases, would not implement an FWP. Future clinical research is needed to systematically design high-quality and feasible clinical trials to determine the benefits and safety of FWPs for patients with dysphagia in these settings. This would lay the foundations for guidelines to support the complex clinical decision-making regarding patient suitability for FWPs.WHAT THIS PAPER ADDS: What is already known on the subject FWPs are an alternate management strategy f...
Source: International Journal of Language and Communication Disorders - March 23, 2022 Category: Speech-Language Pathology Authors: Joanne Murray Shannon Maloney Kaitlyn Underdown Sebastian Doeltgen Source Type: research

Dysphagia: Evaluation and Collaborative Management.
Abstract Dysphagia is common but may be underreported. Specific symptoms, rather than their perceived location, should guide the initial evaluation and imaging. Obstructive symptoms that seem to originate in the throat or neck may actually be caused by distal esophageal lesions. Oropharyngeal dysphagia manifests as difficulty initiating swallowing, coughing, choking, or aspiration, and it is most commonly caused by chronic neurologic conditions such as stroke, Parkinson disease, or dementia. Symptoms should be thoroughly evaluated because of the risk of aspiration. Patients with esophageal dysphagia may report a s...
Source: American Family Physician - January 15, 2021 Category: Primary Care Authors: Wilkinson JM, Codipilly DC, Wilfahrt RP Tags: Am Fam Physician Source Type: research

A rare cause of headache-the importance of a tissue diagnosis and perseverance
A 64 year old diabetic hypertensive milkman presented in September 2011 with 4 months progressive constant right frontotemporal retro–orbital pain. It was worse at night affecting sleep with slight right field blurring and later vomiting. Full examination including blood pressure was normal with acuities 6/9. Tension type headache was considered. Initial brain CT was reported as normal. With concern about giant cell arteritis steroids were trialled although ESR was 8 and CRP 25 with no other clinical features: pain reduction was short–lived and temporal artery biopsy negative. Symptoms worsened despite analgesi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Defty, H., Cavazza, A., Warner, G. Tags: Immunology (including allergy), Cranial nerves, Headache (including migraine), Neurooncology, Pain (neurology), Stroke, Hypertension, CNS cancer, Ophthalmology, Pain (palliative care), Anxiety disorders (including OCD and PTSD), Radiology, Disability, Dru Source Type: research