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BMJ 2011; 343 doi: (Published 06 December 2011) Cite this as: BMJ 2011;343:d7880

Singing is believed to help patients with non-fluent aphasia regain speech after having a stroke, but the rhythm might be more important than the tune. A pilot study of 17 patients assessed the roles of melody and rhythm for promoting speech production, and its results suggest that rhythm is more important, especially for those with basal ganglia lesions. The researchers controlled for variability in vocal frequency, pitch accuracy, rhythm, syllable duration, phonetic complexity, and learning effects (Brain 2011;134:3083-93, doi:10.1093/brain/awr240).

Being discharged from an intensive care unit to a general ward before a tracheostomy has been removed does not carry a survival disadvantage (Critical Care Medicine 2011;39:2240-5, doi:10.1097/CCM.0b013e3182227533). A study in the United States undertook multivariate analyses for ward mortality using data from more than 4000 patients, just under half of whom had needed mechanical ventilation, with 13% requiring tracheotomy. The researchers found that crude ward mortality was similar in patients who were decannulated and in those who were still cannulated.

Is working long …

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