Questions? Comments? Send us a message! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

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, spiritual care provider, physician, lawyer, and social worker. Each perspective offers insights into the challenges of...

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-deficient individuals. The text analyzes various methods of DPD testing, highlighting their limita...

Questions? Comments? Send us a message! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

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, particularly in palliative care settings Onweni C, Rashid S, Goswami R, Treece J, Shipley LC, De Souza R, et al. Cuirass Venti...

Questions? Comments? Send us a message! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

Questions? Comments? Send us a message! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

Questions? Comments? Send us a message! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

Questions? Comments? Send us a message! As we move from the NCHPP website to our new home, we're porting our most popular series: The ACHPN prep course. It's free and may help you with enough questions to pass the darned thing. It's a very poorly written exam, so get all the help you can! You can do it! Support the show Thank you for your interest in Ethics in Palliative Medicine! Follow us at https://epionepalliative.com and on X: @PallCareEthics

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 depression or sedation. It reviews preclinical findings and clinical trial results, showcasing suzetr...

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 symmetrical nature on bone scans. The text further explores the proposed pathophysiological mechanisms, particul...

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 discusses the individualized management of cancer during pregnancy, while the ethics perspective ...

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 mechanism, which involves reducing inflammation and peripheral neurotransmitters, suggests a potential...

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 Ester (CBDA-ME), the effectiveness of cannabis-based medicines, and compare these to traditional...

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, and intractable• Explanation of the hiccup reflex arc and its neurological basis• Overview of the ...

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, emphasizing the importance of recognizing it in palliative care settings. The paper explores RS3PE's...

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 who received consultations. While reductions were observed in other groups (stroke, AMI, COPD), the...

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 accepted medical standards. The case highlights the complexities of defining death in the modern era, the imp...

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 mediated inflammatory nature and its rare association with radiation therapy. The study highlights t...

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 initially suspected of intracerebral hemorrhage whose diagnosis was revised to PRES, leading to...