Topics in Palliative Medicine

Questions? Comments? Send us a message! Recent research indicates that GLP-1 receptor agonists , originally developed for diabetes and obesity, show significant potential in treating substance use disorders (SUDs) and serious mental illnesses. Clinical trials and preclinical studies suggest these medications, such as semaglutide and exenatide , can effectively reduce alcohol cravings and consumpti...

Questions? Comments? Send us a message! We discuss a Phase 2a clinical trial investigating the use of intravenous DMT (SPL026) as a fast-acting treatment for major depressive disorder . The research demonstrates that a single dose, paired with psychotherapeutic support , leads to a rapid and significant reduction in symptoms that can last up to three months. Unlike traditional antidepressants that...

Questions? Comments? Send us a message! This is an interdisciplinary ethics roundtable centered on a terminal lung cancer patient suspected of diverting methadone and violating his controlled substance agreement . Various experts, including physicians, a lawyer, a chaplain, and a psychologist, evaluate the conflict between the duty to relieve suffering and the necessity of maintaining legal and pr...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: The final installment of the prep series focuses on professional issues and leadership. It discusses the "Advocate" role of the ACHPN...

Questions? Comments? Send us a message! This episode presents an "Ethics Roundtable" discussion, focusing on the complex case of a 68-year-old female veteran, LK, whose advanced directive conflicts with her family's wishes regarding life-sustaining treatment. The source explores this ethical dilemma from multiple professional viewpoints, including a trauma surgeon, ethicist, spiritu...

Questions? Comments? Send us a message! This academic article explores the complexities surrounding dihydropyrimidine dehydrogenase (DPD) deficiency screening in patients receiving 5-fluorouracil (5-FU) based chemotherapy. The authors present a case study of a fatal reaction to capecitabine, a prodrug of 5-FU, to illustrate the severe, potentially life-threatening toxicity that can occur in DPD-de...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: This episode focuses on the ethical and legal components of palliative care. It reviews key concepts such as advance directives, surrogate deci...

Questions? Comments? Send us a message! Cuirass Ventilation: An Alternative Home-Based Modality for Chronic Respiratory Failure" explores biphasic cuirass ventilation (BCV) , a portable, non-invasive "forgotten" mode of respiratory support . This article highlights BCV's potential as a comfortable, home-based alternative for patients with chronic respiratory failure, particular...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: Part 4 covers the psychological, social, and spiritual aspects of care. The discussion highlights techniques for effective communication, suppo...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: This session focuses on pain management, a critical component of the board exam. Topics include the assessment of different types of pain, opio...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: Part 2 dives into clinical assessment and physical symptom management. The episode breaks down the pathophysiology of common end-of-life sympto...

Questions? Comments? Send us a message! The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: This introductory episode kicks off the board review series, focusing on the core principles of hospice and palliative nursing. It covers essen...

Questions? Comments? Send us a message! In this episode we discuss  suzetrigine , a novel, non-opioid pain medication that specifically targets the NaV1.8 sodium channel to manage acute pain . The document explores its pharmacological mechanisms , highlighting how it blocks pain signals without causing the addictive or severe side effects associated with traditional opioids like respiratory depres...

Questions? Comments? Send us a message! This episode examines Hypertrophic Pulmonary Osteoarthropathy (HPO) , a rare syndrome often associated with underlying pulmonary malignancies . It outlines HPO's clinical presentation , which includes digital clubbing and painful, swollen joints, emphasizing the importance of differentiating it from metastatic bone pain due to its bilateral and symmetri...

Questions? Comments? Send us a message! In this episode, we discuss a complex ethical dilemma concerning a pregnant woman diagnosed with advanced ovarian cancer who refuses recommended termination and chemotherapy due to prior fertility struggles. Several experts in medicine, ethics, law, spiritual care, and social work provide differing perspectives on the case. The medical oncology perspective d...

Questions? Comments? Send us a message! This case report explores the use of botulinum toxin type A (BTX-A) injections for treating post-thoracotomy pain syndrome (PTPS), a chronic neuropathic condition affecting many patients after thoracotomy. The study highlights that traditional treatments often fail to provide adequate relief, prompting investigation into alternative therapies. BTX-A's m...

Questions? Comments? Send us a message! I. Introduction This briefing document synthesizes key findings from several sources exploring the potential of cannabinoids in managing neuropathic pain. The sources include pre-clinical investigations, clinical trial reviews, and decision analysis models, offering a multifaceted view of the topic. We will examine the potential of Cannabidiolic Acid Methyl...

Questions? Comments? Send us a message! Hiccups, while often seen as a minor inconvenience, can become a significant health issue when they are persistent or intractable. This episode explores the science behind hiccups, their potential medical causes, and treatment options, particularly the use of gabapentin as an off-label solution. • Discussion of the three types of hiccups: acute, persistent,...

Questions? Comments? Send us a message! This case report details a patient with chronic lymphocytic leukemia whose initially misdiagnosed joint pain was ultimately attributed to the rare syndrome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE). The report discusses RS3PE's characteristics, often overlooked due to its rarity and lack of definitive diagnostic criteria...

Questions? Comments? Send us a message! This retrospective study from a 21-hospital system analyzed the effect of palliative medicine consultations on 30-day hospital readmission rates for patients with six diagnoses (heart failure, sepsis, pneumonia, COPD, AMI, and stroke). The research found statistically significant reductions in readmissions for heart failure, sepsis, and pneumonia patients wh...

Questions? Comments? Send us a message! This article presents an ethics case study concerning a 52-year-old male declared brain dead, whose family refuses to remove life support. Multiple perspectives—medical, nursing, chaplain, social work, legal, and ethical—are offered, exploring the conflict between the family's emotional denial of death and the medical team's obligation to uphold ac...

Questions? Comments? Send us a message! This case report details a rare instance of post-radiation lichen planus in a 64-year-old male, following radiation therapy for squamous cell carcinoma. The report examines the patient's medical history, clinical presentation, and treatment response to topical triamcinolone. The authors review existing literature on lichen planus, emphasizing its T-cell...

Questions? Comments? Send us a message! This case report and accompanying discussion detail Posterior Reversible Encephalopathy Syndrome (PRES), a neurological condition presenting with seizures, visual disturbances, and altered mental status. Often misdiagnosed as more severe conditions like intracranial hemorrhage, PRES demonstrates reversible brain swelling on MRI. The case highlights a patient...

Questions? Comments? Send us a message! The BJR method is a novel mathematical approach to methadone conversion that aims to improve upon existing methods by providing a smoother, less discontinuous, and less linear output for a reasonable and safe methadone dose. Here's how it improves upon existing conversion approaches: Addresses Limitations of the Plonk Method: The Plonk method uses a lin...

Questions? Comments? Send us a message! The case study underscores the potential for misinterpreting spiritual distress as psychiatric illness, resulting in inappropriate treatment.  Clinicians should learn several key lessons from the case of Mr. G, primarily emphasizing the importance of addressing patients' spiritual needs alongside their physical ailments. Open communication: Clinicians s...