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Clinical assessment and management of communication in older adults
Published in Rebecca Allwood, Working with Communication and Swallowing Difficulties in Older Adults, 2022
Sometimes, a diagnosis is not fully known until it is seen how the symptoms develop with the passage of time. For instance, word finding difficulties can be an early symptom of dementia but might also be a simple age-related change. Voice changes can be the first symptom of a progressive neurological disorder or just a temporary impairment related to lifestyle factors such as poor voice care.
Possession states and allied syndromes
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
The various features recorded by these authors are not described as being invariably present in every case. They can be categorised in the following manner:History – involvement in the occult; a lifetime of wicked or immoral behaviour.Physical features – psychosomatic pains; the vomiting of unusual objects; a bilious complexion; physical wasting; an habitual frightening facial expression; great physical strength.Voice changes – compulsive utterances, usually obscenities; glossolalia (speaking in tongues); speaking in a voice that is not that of the sufferer, often a deep and uncouth voice; an ability to understand and converse in a language unknown to the sufferer; making the noises of an animal.Behavioural changes – forced movements including convulsions; resistance to participation in prayer; a tendency to curse and blaspheme; marked fear when in the presence of religious symbols or ritual.Mental phenomena – a trance-like state; amnesia on recovery.Other “paranormal” activities – powers of clairvoyance; poltergeist phenomena.
Stammering and voice
Published in Trudy Stewart, Stammering Resources for Adults and Teenagers, 2020
Medical: Co-occurring medical issues may contribute to voice change e.g. reflux (indigestion), heart conditions, thyroid, asthma and allergies. Previous surgeries, particularly those requiring intubation, can cause laryngeal trauma. Also, some medications tend to dry the laryngeal mucosa and the protective mucosal layer covering the vocal cords themselves.
Student perceptions of factors that influence clinical competency in voice
Published in International Journal of Speech-Language Pathology, 2021
Anna F. Rumbach, Katherine Dallaston, Anne E. Hill
In addition to the belief that a clinician’s own voice underpins clinical competency in voice, participants identified students’ own voices as impacting their development and attainment of clinical competency: “I feel like your natural voice is a factor” – FG2P5; “I think it really depends on your voice as well” – FG2P4. Participants explained the ways in which a student’s own voice impacts upon competency by giving examples of why, if students do not have adequate voices, competency is not achieved. One participant believed that poor vocal health compromises the (perceived) legitimacy of a clinician’s advice to others: “Your own voice quality makes you feel like you shouldn’t be giving someone else vocal advice and vocal hygiene because you don’t feel that your own voice is very up to par.” – FG2P1. Participants also spoke of the impact of poor vocal health on students’ capacity to elicit voice change in their patients: “…obviously if you have a disordered voice then it makes it very difficult to teach voice unless it’s ‘do as I say, not as I do.’” – FG3P1. Similarly, under-developed vocal skill was identified as a barrier to eliciting voice change in patients. One participant stated, quite simply, “If I can’t do it, how am I going to get other people to do it?” – FG2P2.
Nomogram prediction for the involution of the ablation zone after radiofrequency ablation treatment in patients with low-risk papillary thyroid carcinoma
Published in International Journal of Hyperthermia, 2021
Hongying He, Yan Zhang, Qing Song, Jiahang Zhao, Wen Li, Yi Li, Yukun Luo
The patient characteristics are presented in Table 1. A total of 204 patients (158 female and 46 male) with low-risk PTC ≤4 cm diagnosed from January 2018 to January 2019 were enrolled in this study. Of all patients, the mean age was 43.25 ± 10.47 years (range 21–72 years). The mean size of the primary tumors was 0.8 ± 0.47 cm (range 0.3–3.8 cm). According to the analysis, eventually, 126 (62%) patients experienced ablation zone disappearance within 12 months after RFA, 76 (37%) patients displayed ablation necrosis with no active tumor cells, and 2 (1%) patients displayed ablation necrosis with active tumor cells present on CNB, which were performed at 6 months or later after RFA [24]. In the group where the ablation zone did not disappear, there were 10 tumors presenting with 1–2 mm calcification and 2 cases with calcification larger than 2 mm, which was higher than that in the group with complete disappearance. There was only one patient in the group with complete disappearance having local tumor recurrence after RFA. Complications were observed in one patient who experienced voice change and two that experienced moderate pain.
Microwave ablation versus radiofrequency ablation for primary hyperparathyroidism: a multicenter retrospective study
Published in International Journal of Hyperthermia, 2021
Ying Wei, Cheng-zhong Peng, Shu-rong Wang, Jun-feng He, Li-li Peng, Zhen-long Zhao, Xiao-jing Cao, Yan Li, Hui-hui Chai, Ming-an Yu
Major complication – voice change encountered in five patients (6.5%) in the MWA group and in one patient (3.7%) in the RFA group. Five patients’ voices recovered completely within 6 months after ablation. One patient’s voice change was relieved by medications, including corticosteroids and physiotherapy, but they still experienced persistent voice impairment throughout the follow-up period. Two (2.6%) out of 77 patients in the MWA group exhibited minor complications – hematomas, which recovered within one week without sequelae. Side effects (fever, headache and numbness), hypocalcemia and transient hypoparathyroidism all rapidly recovered within 1 month without any specific therapy. There were no significant differences in posttreatment complications, side effects, transient hypoparathyroidism or hypocalcemia between the MWA and RFA groups (complications, 9.1% vs. 3.7%, p = .677; side effects, 22.1% vs. 29.6%, p = .442; transient hypoparathyroidism, 37.7% vs. 66.7%, p = .013; hypocalcemia, 2.6% vs. 7.4%, p = .276) (Table 2).