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When the patient can't walk away.
J Med Ethics
January 2025
Rehabilitation Medicine, NHS Lothian, Edinburgh, UK
When the clinician and patient are unable to reconcile differences over treatment, does this mean the latter lacks capacity to decide in such matters? Wellesley analyse the legal judgements in the case of Ms Sudiksha Thirumalesh where, on the particulars, the Court of Protection answered yes, only for the Court of Appeal to disagree. The authors highlight concerns about using isolated false belief as an indicator of incapacity and advise that such matters may be better resolved by greater discussion of the benefits and burdens of treatment, alongside consideration of their costs. Here, I suggest that a disability perspective is also helpful to such cases, recognising that this was a disagreement from which the patient couldn't walk away.
View Article and Find Full Text PDFUnlocking hidden treasures: the evolution of high-throughput mass spectrometry in screening for cryptic natural products.
Nat Prod Rep
January 2025
Department of Chemistry, Princeton University, Princeton, New Jersey 08544, USA.
Covering: 1994 to 2024Historically, microbial natural product discovery has been predominantly guided by biological activity from crude microbial extracts with metabolite characterization proceeding one molecule at a time. Despite decades of bioactivity-guided isolations, genomic evidence now suggests that we have only accessed a small fraction of the total natural product potential from microorganisms and that the products of the vast majority of biosynthetic pathways remain to be identified. Here we describe recent advancements that have enabled high-throughput mass spectrometry and comparative metabolomics, which in turn facilitate high-throughput natural product discovery.
View Article and Find Full Text PDFSuccessful Laparoscopic Sleeve Gastrectomy in a Patient With Rare Congenital Factor VII Deficiency: A Case Report and Management Strategy.
Cureus
December 2024
Department of Surgery, King Abdulaziz Specialist Hospital, Taif, SAU.
Congenital factor VII (FVII) deficiency is a rare coagulation disorder that increases the risk of bleeding complications during surgery. Although laparoscopic sleeve gastrectomy (LSG) is the most common metabolic bariatric surgery (MBS), it is rarely performed in patients with congenital coagulation disorders such as FVII deficiency, due to the high risk of intraoperative and postoperative bleeding. We report the case of a 57-year-old female with class II obesity (BMI 37.
View Article and Find Full Text PDFPeritonitis following duodenal injury due to seatbelt trauma: A case manifesting immediately post-surgery for thoracolumbar fracture-dislocation.
Int J Surg Case Rep
January 2025
Department of Orthopedic Surgery, Naha City Hospital, Okinawa, Japan.
Introduction: Although abdominal organ damage due to motor vehicle accident is often evident immediately after the injury and urgent operation is performed, it has been reported that minor injuries such as hollow viscus may become apparent during the course of treatment and require urgent surgery.
Case Report: The Authors present the case of a 42-year-old female who developed peritonitis immediately after undergoing surgery for thoracolumbar fracture-dislocation caused by a traffic accident. The patient exhibited no abdominal symptoms, such as nausea, vomiting, or abdominal wall rigidity, and had no difficulty with oral intake preoperatively.
Laparoscopic Resection of an Isolated Myometrial Metastasis From Ileocecal Cancer: A Case Report.
Cureus
December 2024
Pathology, Social Insurance Tagawa Hospital, Tagawa, JPN.
A 67-year-old woman was diagnosed with ileocecal cancer presenting with intestinal obstruction. She underwent an ileocecal resection and D3 lymph node dissection. Pathological diagnosis showed a moderately differentiated adenocarcinoma, pT4aN0M0.
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