Mastodon Sometimes 3 nephrons are all you need ~ Pallimed

Monday, July 3, 2006

Sometimes 3 nephrons are all you need

I'm emerging from my new-father cocoon and, well, there are so many things to blog I don't know where to begin. Here are a few blurbs for now & hopefully in the next week or so I'll begin blogging again in earnest.

Oxymorphone extended release oral tabs have been approved in the US. A nice review of oxymorphone is here (& blogged about previously here).

An update on Art Buchwald: he's still alive, and--per this NPR report--is planning on leaving his hospice to go to his summer home on Martha's Vineyard. Sometimes three nephrons are all you need.

June PC-FACS are out.

The Journal of the Canadian Dental Association has a review of oral problems for the palliative care patient. (I was able to access free full-text of this article here.) It is a general and well-written review (mucositis, thrush, xerostomia, etc.), and it's nice to see a topic like this mentioned in a non-palliative care journal.

The European Journal of Cancer has an interesting article looking at clinical trials of so-called palliative chemotherapy for colon cancer, attending to whether or not the authors' interests in the trial outcomes are really palliative or life-prolonging. Part of this has to do with the ongoing confusion about 'palliative chemotherapy'--is it chemo given with the sole intention of improving quality of life or is it 'non-curative' chemotherapy given with the intention of prolonging life? The authors analyze multiple trials of chemo for advanced colon cancer, and essentially conclude that prolongation of life is generally the primary outcome priority of these trials, even if they are of 'palliative' chemotherapy. To be honest, I thought the article was somewhat contrived--using a 'straw man' rhetorical technique of a supposed mis-use of 'palliative' to describe chemotherapy even if the authors didn't actually do that. And, frankly, while quality of life outcomes should be standard for all trials involving advanced, non-curable cancers, what's wrong with evaluating primarily life-prolongation? Most patients would agree. Nevertheless I thought it was notable that someone was actually trying to formally look at the intentions and outcomes of chemotherapy for advanced cancers in this way.

An interesting secondary finding of their analysis is that, for the articles they evaluated, the presence of toxicity from chemotherapy didn't seem to have much impact on whether or not the chemotherapy had a positive quality of life impact.

I'm so damn proud of this baby:

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