Topics in Palliative Medicine
Articles from the medical literature are digested, abstracted, and discussed by our AI hosts, with topics in symptom management, diagnosis, ethics and others.
Episodes
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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 consumption by modulating the brain's rew...
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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 take weeks to work, this short-actin...
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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 professional boundaries. The contribut...
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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, quality improvement processes, and...
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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, spiritual care provider, physician, lawyer...
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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-deficient individuals. The text analy...
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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 decision-making, autonomy, beneficence, ...
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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, particularly in palliative care settings
On...
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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, supporting grieving families, and address...
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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, opioid titration, managing side effects,...
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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 symptoms and discusses evidence-based phar...
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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 essential domains, including the field&ap...
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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 depression or sedation. It reviews preclinica...
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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 symmetrical nature on bone scans. The text fur...
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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 discusses the individualized managem...
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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 mechanism, which involves reducing i...
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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 Ester (CBDA-ME), the effectiveness o...
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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, and intractable
• Expl...
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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, emphasizing the importance of rec...
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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 who received consultations. While red...
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