This book is written for the beginning student of communication disorders with a basic understanding of phonetics, or the practising speech-language therapist whose phonetic training may need ...updating. It introduces the reader to the main areas of phonetics, and the main methods through which the phonetician reduces speech data to a permanent record. The book, then, illustrates the three main approaches to the investigation of spoken language; articulatory, acoustic, and auditory. Further, it describes how impressionistic phonetic transcription through symbolisation differs from instrumental phonetic techniques. For each of these areas of discussion, chapters are provided that examine the general phonetic aspects, followed by chapters that illustrate their application to clinical data.
: Patients with severe haemophilia A usually present with joint, gastrointestinal and urinary tract haemorrhage. Bleeding elsewhere is often precipitated by pre‐existing pathology or trauma. We ...report a patient with severe haemophilia A, who presented with symptoms of acute intestinal obstruction. He has a factor VIII inhibitor and receives recombinant factor VIIa on demand at home. The CT scan of abdomen showed dilated small intestine with fluid filled loops and a long segment in the jejunum with marked transmural thickening. There was no other pathology in the small intestine. These appearances were consistent with intramural haemorrhage in the small intestine as the cause of acute obstruction. He was managed conservatively with recombinant factor VIIa and this resulted in resolution of his symptoms. This case highlights an unusual presentation of bleeding in a haemophilia patient. Intestinal obstruction due to haemorrhage in the small intestinal wall is extremely rare and only previously reported in a few haemophilia patients. It also highlights the effectiveness of conservative management with recombinant factor VIIa as opposed to immediate exploratory surgery.
