Literature Review

Delivering effective messages in the patient-clinician encounter JAMA, by Joseph N. Cappella, PhD and Richard L. Street Jr, PhD; 2/1/24Effective communication between patient and clinician is a core function of the medical encounter.In a survey of cancer survivors, communication breakdowns most often identified by respondents were failures of information exchange, both in information provided by the clinician (eg, too complex, not enough) and in missing information from the patient or failing to elicit it. ... [A] table provides specific examples of what clinicians can (and should not) do to accomplish [effective communication] goals.

Joint inpatient palliative care approaches may reduce length of stay in intensive care unitsPhysician's Weekly; 2/7/24Patients in the intensive care unit (ICU) would benefit from having an Inpatient Palliative Care (IPC) team to help them through this difficult chapter in their lives. An IPC team usually help patients manage their symptoms and pain along with providing support to them and their families and assisting with communication to ensure realistic expectations.

 Where do we end our lives? American Council on Science and Health, by Chuck Dinerstein, MD, MBA; 2/5/24The concept of an elephant's graveyard, where old elephantes supposedly go to die, is more of a myth than a scientifically supported phenomenon. Humans do not have a specific location where we gather to die, but a study looks into the matter nevertheless.

Emergency department management of common end-of-life and palliative care symptoms: Three casesCureus, by Alice Chang, James Espinosa, Alan Lucerna; 2/4/24... Patients with serious illness, even hospice patients, present to the ED in increasing numbers for symptom management. It has become essential for emergency physicians to care for patients who are not seeking life-sustaining measures but instead need quality-of-life interventions. The development of a clear, concise review of the most common acute symptoms can provide a framework for EM physicians to adequately address the needs of patients at the EOL.

A pathophysiological approach for selecting medications to treat nociceptive and neuropathic pain in servicemembersMil Med, by Khan Thi Nguyen, Daniel W Beauchamp, Reginald B O'Hara; 1/31/24The prevalence of chronic pain of service members (SMs) in the U.S. is estimated to be higher (roughly 31-44%) compared to that of civilian population (26%). This higher prevalence is likely due to the high physical demands related combat and training injuries that are not immediately resolved and worsen over time. Mental Health America reports that chronic pain can lead to other mental health conditions such as severe anxiety, depression, bipolar disorder, and post-traumatic stress disorder.

Odds for dementia nearly triple in the year after a strokeHealth Day, by Ernie Mundell; 2/1/24A person's odds for a dementia diagnosis nearly triple in the first year after a stroke, new research shows. This post-stroke spike in dementia risk does subside with time, but it never returns to pre-stroke levels, the same report found. "Our findings reinforce the importance of monitoring people with stroke for cognitive decline," said lead researcher Dr. Raed Joundi. 

Global cancer burden growing, amidst mounting need for services World Health Organization; 2/1/24Ahead of World Cancer Day, the World Health Organization (WHO)’s cancer agency, the International Agency for Research on Cancer (IARC), released the latest estimates of the global burden of cancer.  ... Three major cancer types in 2022: lung, breast and colorectal cancers

Nurses' encounters with patients having end-of-life dreams and visions in an acute care setting - A cross-sectional survey studyJ Adv Nurse, by Alison Hession, Tim Luckett, David Currow, Michael Barbato; 1/31/24Results: Fifty-seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end-of-life dreams and visions. The nature of end-of-life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end-of-life dreams and visions but identified an unmet need for education and training on this aspect of end-of-life care.Editor's Note: This research was in Australia, yet has global applications. For U.S. leaders, call on your chaplains, many of whom are trained pastoral counselors to sensitively support and explore patient's "dreams and visions," in non-manipulative ways.

Breakthroughs in Alzheimer's research give cause for optimismKiplinger, by Elaine Silvestrini; 1/29/24... Finding a cure or even an effective treatment has been difficult. Now, after billions of dollars in research and more than 100 drug failures, advocates are celebrating breakthroughs, including drugs that for the first time treat the underlying causes of the disease. Experts are optimistic that we may be on the precipice of significant changes in how the disease is treated and potentially even prevented. 

Cannabis for neurodegenerative disordersCannabis - Science and Technology, by Ruth Fisher; 1/30/24In this blog installment, we take a deep dive into research on how cannabis affects neurodegenerative disorders such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease. ... The information presented in this section comes from the Cleveland Clinics, a nonprofit academic medical center.

Predictors of early hospice or death in patients with inoperable lung cancer treated with curative intentClin Lung Cancer, by Siddharth Ramanathan, Kimberly A Hochstedler, Anna M Laucis, Benjamin Movsas, Craig W Stevens, Larry L Kestin, Michael M Dominello, Inga S Grills, Martha Matuszak, James Hayman, Peter A Paximadis, Matthew J Schipper, Shruti Jolly, Thomas P Boike; Michigan Radiation Oncology Quality Consortium; NCBI published 1/31/24Introduction: Treatment for inoperable stage II to III non-small cell lung cancer (NSCLC) involves chemo-radiotherapy (CRT). However, some patients transition to hospice or die early during their treatment course. We present a model to prognosticate early poor outcomes in NSCLC patients treated with curative-intent CRT.

Ethical issues in pain and palliationCurr Opin Anaesthesiol, by Marco Cascella, Alessandro Laudani, Giuliana Scarpati, Ornella Piazza; 1/30/24Summary: Palliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too. Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility. Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.