However, there is little evidence to suggest that withdrawal or modification of 2022 fluids reduces the incidence of pneumonia. Oral hygiene is impaired by the withdrawal of oral fluids, and aspirated saliva (up to 2 litres/day) may be infected as a result. Medications are not given orally, and patients may be distressed by the withholding of oral fluids. The research question is whether allowing people with evidence of aspiration free access to water predisposes them to the development of aspiration pneumonia compared with withdrawal of oral liquids or the use of modified (thickened) oral fluids. [2008] 5 Aspirin and anticoagulant treatment for acute ischaemic stroke Does modified-release dipyridamole or clopidogrel with aspirin improve outcome compared with aspirin alone when administered early after acute ischaemic stroke? Why this is important Aspirin administered within 48 hours of acute ischaemic stroke improves outcome compared with no treatment or early anticoagulation. In the secondary prevention of stroke, the combination of modified-release dipyridamole with aspirin improves outcome compared with aspirin alone. Clopidogrel, administered with aspirin, improves outcome after myocardial infarction. It is not known whether antiplatelet agents other than aspirin (alone or in combination) may be more effective than aspirin alone in the acute phase of ischaemic stroke. The research question to be addressed is whether modified-release dipyridamole or clopidogrel with aspirin improves outcome compared with aspirin alone when administered early after acute ischaemic stroke. [2008] 6 Aspirin treatment in acute ischaemic stroke Should a person who has a stroke or a TIA and is already taking aspirin be prescribed the same or an increased dose of aspirin after the stroke? Why this is important Many people take aspirin routinely for the secondary or primary prevention of vascular disease. 