Brit J Hosp Med
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Cauda equina syndrome is an uncommon but serious cause of lower back pain resulting from compression of the cauda equina nerve roots, most commonly by lumbar disc herniation. Red flag symptoms, such as bladder dysfunction, saddle anaesthesia and sciatica, should lead to high clinical suspicion of cauda equina syndrome. ⋯ Immediate magnetic resonance imaging, within 1 hour of presentation to the emergency department, is crucial in patients with suspected cauda equina syndrome to allow prompt diagnosis and treatment. Urgent decompressive surgery is usually recommended for the best outcomes, to reduce morbidity and complication rates.
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Artificial intelligence is paving the way in contemporary medical advances, with the potential to revolutionise orthopaedic surgical care. By harnessing the power of complex algorithms, artificial intelligence yields outputs that have diverse applications including, but not limited to, identifying implants, diagnostic imaging for fracture and tumour recognition, prognostic tools through the use of electronic medical records, assessing arthroplasty outcomes, length of hospital stay and economic costs, monitoring the progress of functional rehabilitation, and innovative surgical training via simulation. However, amid the promising potential and enthusiasm surrounding artificial intelligence, clinicians should understand its limitations, and caution is needed before artificial intelligence-driven tools are introduced to clinical practice.
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The emerging field of perioperative medicine has the potential to make significant contributions to global health. Perioperative medicine aims to help reduce unmet surgical need, decrease variation in quality and systematically improve patient outcomes. These aims are also applicable to key challenges in global health, such as limited access to surgical care, variable quality and workforce shortages. This article describes the areas in which perioperative medicine can contribute to global health using case studies of successful care pathways, risk prediction tools, strategies for effective grassroots research and novel workforce approaches aimed at effectively using limited resources.
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As medical assistance in dying seemingly gains traction, this editorial discusses the arguments for and against it, looking at the balance of patient autonomy and alleviation of suffering vs the potentially far-reaching and unintended consequences. The authors hope that this provides a platform for further debate and education around assisted dying.