Absence of monitoring in withdrawal of clinically-assisted nutrition and hydration (CANH) and other treatments: a cause for concern?

Since 2018, there has been no requirement to bring decisions about the withdrawal of clinically-assisted nutrition and hydration (CANH) in patients with persistent disorders of consciousness before the courts, providing that the requirements of the Mental Capacity Act 2005 (MCA) are fulfilled. Subsequent British Medical Association and Royal College of Physicians guidance on CANH withdrawal recommended standards of record keeping and internal and external audit to ensure local decision making was compliant with the MCA to safeguard patients. The scope of the guidance also included patients with stroke and neurodegenerative disorders.

First reported case of posterior reversible encephalopathy syndrome occurring in a weightlifter.

Posterior reversible encephalopathy syndrome (PRES) is an increasingly well recognised clinical and radiological condition. Here we report on the first known published case of PRES in a weightlifter. We present a 34-year-old man with acute onset visual disturbance and expressive dysphasia which occurred after an intensive gym session.