Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Jul;56(7-08):536-543. doi: 10.1055/a-1203-2826. Epub 2021 Jul 23.ABSTRACTThe therapy of brain-dead pregnant women is an extreme example not only of the possibilities in current critical care, but also of resulting ethical, social and legal controversies, an area not familiar to most clinicians. Based on the case of a patient with fatal traumatic brain injury, a previously unknown early pregnancy and stated will to donate organs, we will discuss several aspects using published case reports: therapeutic goals, especially palliative care vs. continuation; implications of brain death diagnosis; considerations on legal care; involvement of relatives, especially the child’s…
Origen: Ethical, Psychosocial and Legal Aspects of the Treatment of Pregnant Patients with Brain Death – PubMed

Int J Mol Sci. 2021 Jul 4;22(13):7204. doi: 10.3390/ijms22137204.ABSTRACTTherapy targeting immune checkpoints represents an integral part of the treatment for patients suffering from advanced melanoma. However, the mechanisms of resistance are responsible for a lower therapeutic outcome than expected. Concerning melanoma, insufficient stimulation of the immune system by tumour neoantigens is a likely explanation. As shown previously, radiotherapy is a known option for increasing the production of tumour neoantigens and their release into the microenvironment. Consequently, neoantigens could be recognized by antigen presenting cells (APCs) and subjected to effector T lymphocytes. Enhancing the immune reaction can trigger the therapeutic response…
Origen: The Abscopal Effect in the Era of Checkpoint Inhibitors – PubMed

BMJ. 2021 Jul 14;374:n1776. doi: 10.1136/bmj.n1776.NO ABSTRACTPMID:34261622 | DOI:10.1136/bmj.n1776
Origen: Dying at home during covid-19: a view from primary care – PubMed

FP Essent. 2021 Jul;506:31-42.ABSTRACTEnd-stage heart failure (HF) is associated with an extremely poor prognosis. Progressive and/or persistent HF signs and symptoms in the setting of optimal therapy is the hallmark of more advanced disease. Physicians must be able to recognize patients with features of refractory HF to aid in timely evaluation for advanced therapy options. Left ventricular assist device implantation and heart transplantation prolong survival in patients with end-stage HF, but are options only for select patients. Timely referral for evaluation is necessary to prevent secondary irreversible end-organ dysfunction and to ascertain whether there are factors that can be addressed…
Origen: Heart Failure: Advanced Refractory Heart Failure – PubMed

J Opioid Manag. 2021 May-Jun;17(3):207-214. doi: 10.5055/jom.2021.0631.ABSTRACTA growing number of individuals live with an opioid use disorder (OUD). While many go on to recover from such disorders, certainly, there will be individuals in palliative care (PC) at some point who still suffer with OUD. One of the major barriers to PC for individuals recovering and currently suffering from an OUD is the stigma related to having an OUD. Therefore, in the context of PC, it is important to understand the relationship that exists between PC, OUDs, and how stereo-types related to substance use disorders affect patient engagement in PC. For…
Origen: Meeting at the crossroads of pain and addiction: An ethical analysis of pain management with palliative care for individuals with substance use disorders – PubMed