Wednesday, May 30, 2007
1)Journal of Clinical Oncology has a wonderful 'art of oncology' piece written by a social worker about the 0-10 pain scale (free full-text appears to be available). It describes her experience being in severe pain in the hospital and, essentially, having her experience of pain, her suffering, erased by her care-providers' insistence on...
Wednesday, May 30, 2007
Here is a listing of many online resources for prognostication near the end-of-life. This post is made after a request from a audience member at a talk I gave recently on Evidence-Based Prognostication. My plan is to update these links and qualify them over the next several weeks. Please feel free to add more in the comments section or email them to me.The following links are for medical use only (i.e. they are not party tricks!)....
Tuesday, May 29, 2007
I'm traveling the end of this week as well so this will likely be another sparse posting week for me. I'll be at the CSPCP's Advanced Learning in Palliative Medicine conference ( .pdf here) - say Hi if you run into me.A couple of articles from Annals of Oncology... 1)First is a look at using the B12/CRP index for prognosticating in advanced...
Tuesday, May 29, 2007
Thursday, May 24, 2007
Kevin MD has been keeping the blogosphere up to date on the sudden loss of two anonymous physician bloggers, Flea (archived blog) and Fat Doctor. For those of you not following all of this, basically the medical blogging community comes in two flavors, anonymous and not.The anonymous bloggers have the ability to demonstrate some of the...
Thursday, May 24, 2007
Wednesday, May 23, 2007
Jessica Israel, the chief of geriatrics and palliative medicine at Monmouth Medical Center (Long Branch, N.J.), wrote a great article in the NY Times describing the hard work palliative medicine professionals do.It is very well written. (Hey we are not always critical here!)Some of my favorite quotes are:I knew I had an agenda that night,...
Wednesday, May 23, 2007
1) Nature published a study out of Brown demonstrating the persistent effects of morphine in the brains of mice. Reading the study (quite dense on the receptor type stuff) they basically found that morphine inhibits long term potentiation of GABA mediated synaptic transmission. In a press release they describe it as this:So the net effect...
Wednesday, May 16, 2007
**I just republished this post because for some reason it wouldn't allow readers to comment. Email me directly if that is still the case. --Drew**Happy belated Nurses’ Week for all of the nurses who follow the blog and those who love - or at least professionally admire - them. I am traveling through next week and this may be my last post...
Wednesday, May 16, 2007
Saturday, May 12, 2007
OxyContin guilty pleas; 1-year mortality post hospitalization; Dying art of the condolence letter; Opioids, pain, & addiction
1)If you haven't heard already, several top executives for Purdue Pharma have plead guilty to criminal charges from misleading doctors about the safety of OxyContin. NY Times has a pretty good story about it here. Some of the article's rhetoric is a little off - "OxyContin is a pure, high-strength version of a long-used narcotic, oxycodone,"...
Saturday, May 12, 2007
Thursday, May 10, 2007
The New England Journal of Medicine published an update (usually every 5 years) on the practice of physician-assisted death (used here to describe euthanasia (E) and physician-assisted suicide(PAS)) under the legal Netherlands Euthanasia Law (2002). There have been previously published articles in NEJM reviewing acts of hastened death...
Thursday, May 10, 2007
Wednesday, May 9, 2007
1) This last Monday I gave a talk to our palliative medicine fellowship program about topical and transdermal medication in palliative care. While I am generally not a big fan of topical/compounded medications (because of a general lack of efficacy research or basic science studies for many), I did come across a case series of 4 patients who received topical methadone for open wound pain management. I have worked with morphine...
Wednesday, May 9, 2007
Tuesday, May 8, 2007
In no particular order: 1)Critical Care Clinics has an ethical review of discontinuation of mechanical ventilation at the end of life. It’s actually a rather free-wheeling review of the U.S. legal and ethical framework for withdrawal of life-prolonging treatments in the dying. It’s a good one for the teaching file. The same issue...
Tuesday, May 8, 2007
Thursday, May 3, 2007
1) If you have not gone over to see HospiceGuy and his HospiceBlog (www.hospiceblog.org) you are missing out on some great posts. HospiceGuy is on a roll with some insight about the role of the chaplain in hospice, the NHPCO conference, hospice leadership and a quick overview of the Medicare Wage Index for 2008. On the wage index, the...
Thursday, May 3, 2007
Wednesday, May 2, 2007
1)The Clinical Journal of Pain has a study on the long-term use of opioids for chronic non-malignant pain (CNMP). The study looked at 230 patients taking extended release oxycodone after completing short term, controlled trials for CNMP (DJD, low back pain, diabetic neuropathy) - they agreed to be observed for up to 3 years while taking...
Wednesday, May 2, 2007
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