Chronic pruritus, or persistent itching, is a debilitating condition that severely impacts quality of life, especially in palliative care settings. Traditional treatments often fail to provide adequate relief or are associated with significant side effects, prompting interest in alternative therapies. This review investigates the antipruritic potential of eight medicinal plants: chamomile (Matricaria chamomilla), aloe vera (Aloe barbadensis), calendula (Calendula officinalis), curcumin (Curcuma longa), lavender (Lavandula angustifolia), licorice (Glycyrrhiza glabra), peppermint (Mentha piperita), and evening primrose (Oenothera biennis). These plants are analyzed for their traditional applications, active bioactive compounds, mechanisms of action, clinical evidence, usage, dosage, and safety profiles. Comprehensive searches were conducted in databases including PubMed, Web of Science, Scopus, and b-on, focusing on in vitro, animal, and clinical studies using keywords like “plant”, “extract”, and “pruritus”. Studies were included regardless of publication date and limited to English-language articles. Findings indicate that active compounds such as polysaccharides in aloe vera, curcuminoids in turmeric, and menthol in peppermint exhibit significant anti-inflammatory, antioxidant, and immune-modulating properties. Chamomile and calendula alleviate itching through anti-inflammatory and skin-soothing effects, while lavender and licorice offer antimicrobial benefits alongside antipruritic relief. Evening primrose, rich in gamma-linolenic acid, is effective in atopic dermatitis-related itching. Despite promising preclinical and clinical results, challenges remain in standardizing dosages and formulations. The review highlights the necessity of further clinical trials to ensure efficacy and safety, advocating for integrating these botanical therapies into complementary palliative care practices. Such approaches emphasize holistic treatment, addressing chronic pruritus’s physical and emotional burden, thereby enhancing patient well-being.

Lemon essential oil, derived from Citrus limon, possesses diverse health-promoting properties, including antioxidant, antimicrobial, and mood-enhancing effects. Despite its traditional use in aromatherapy and complementary medicine, there is a need for comprehensive investigations into its therapeutic potential, particularly in mitigating DNA damage and supporting health in palliative care settings. This study aimed to evaluate the antigenotoxic effects of lemon essential oil in human peripheral blood mononuclear cells and to explore its potential applications in palliative care. Treatment with lemon essential oil significantly reduced DNA damage, with 1% w/v with 3.13% DNA in tail demonstrating greater efficacy. Furthermore, lemon essential oil attenuated streptonigrin-induced DNA damage, suggesting a potential protective effect against oxidative stress, especially at 3% w/v, with 11.81% DNA in tail. Compared to olive oil treatment, the DNA damage was significantly lower with streptonigrin treatment alone, which had 47.06% DNA in tail, while the olive oil treatment resulted in 36.88% DNA in tail. These results can be attributed to the main constituents: limonene in lemon essential oil and oleic acid in olive oil. These results suggest a potential role in mitigating oxidative stress and supporting genomic stability. Further research is warranted to elucidate the mechanisms of action and clinical applications in palliative care.

Mental fatigue poses a significant challenge to healthcare professionals in hospital settings, impairing cognitive performance, emotional well-being, and job satisfaction. This systematic review evaluates the effectiveness of cognitive interventions, including mindfulness programs, online psychological interventions, and telehealth cognitive-behavioral therapy (CBT), in mitigating mental fatigue among healthcare workers. A comprehensive literature search across PubMed, b-on, Web of Science, and Scopus identified six studies published between 2016 and 2023. These studies reported that cognitive interventions significantly reduced burnout and stress levels, with up to a 30% decrease in emotional exhaustion and improved coping mechanisms. In addition, participants demonstrated enhanced emotional well-being, reflected in increased mindfulness and life satisfaction scores of as much as 25%. Mindfulness-based programs and telehealth CBT were particularly effective in fostering resilience and improving overall cognitive function. However, the review also highlighted the need for future research to explore the long-term effects of these interventions, their cost-effectiveness, and innovative methods to improve accessibility and scalability, such as digital platforms. Integrating cognitive interventions into routine healthcare practice can enhance staff well-being, improve patient outcomes, and contribute to a more supportive work environment.

Background: Palliative Care is concerned with relieving suffering and improving the quality of life of patients and their families. Currently, questions arise about how to provide patients with good end-of-life care. There has been increasing interest in the beneficial effects of using psilocybin-assisted therapy in patients with severe chronic illnesses near the end of their lives and who present symptoms of depression and/or anxiety. Aim: Explore the role of psilocybin-assisted therapy in palliative care, synthesizing evidence from clinical trials and longitudinal studies. Design: Systematic review. Data sources: A bibliographic search was performed in April 2024 in B-on, PubMed, Web of Science, and Scopus. Eligible studies included peer-reviewed quantitative research (RCTs, longitudinal, and observational designs) with adult participants in palliative care settings, examining the efficacy and safety of psilocybin-assisted therapy. Reviews, gray literature, and studies outside the scope of palliative care were excluded. Results: Of the 215 articles found, six studies ( n = 74 participants; age range 22–75 years) met the inclusion criteria. Across randomized and open-label trials, psilocybin-assisted therapy produced clinically significant reductions in depression and anxiety, with 57–79% of participants achieving ⩾ 50% symptom reduction on standardized scales (e.g. HAM-D, HAM-A, BDI, STAI). Improvements were sustained for up to 6–8 months in most trials, and in one follow-up study, for up to 4.5 years. Reported adverse effects were generally mild and transient, including nausea, vomiting, and temporary increases in blood pressure and heart rate; no serious adverse events were observed. Conclusions: Psilocybin-assisted therapy consistently demonstrated efficacy and safety in the reduction of depressive and anxiety symptoms. However, more studies exploring integrating psilocybin-assisted therapy into existing palliative care healthcare systems are needed. This includes investigating the feasibility, acceptability, and cost-effectiveness of integrating psilocybin-assisted therapy into routine clinical practice.

As crises convulsivas têm habitualmente grande impacto nos doentes e seus cuidadores, constituindo assim, quer, pela sua frequência, quer pelo seu potencial de gravidade, uma urgência em cuidados paliativos. O nosso objetivo foi identificar os anticonvulsivantes utilizados em cuidados paliativos, suas características farmacodinâmicas e vias de administração. Elaborar um algoritmo de tratamento da crise convulsiva, segundo o estado da arte, para doentes em internamento e ambulatório. Trata-se de um estudo de revisão da literatura, desenvolvido com a finalidade de reunir e sintetizar a informação sobre o uso de anticonvulsivantes no adulto em cuidados paliativos. A sumarização, em modo consulta rápida, das indicações, vias de administração e dosagem relativamente ao uso de anticonvulsivantes permite em formato prático auxiliar as equipas no âmbito dos cuidados de saúde primários e hospitalares na abordagem da crise epiléptica no doente paliativo. Como resultado desta revisão, realça-se o algoritmo de atuação e a sumarização dos anticonvulsivantes mais utilizados em cuidados paliativos e do uso do levetiracetam e da lacosamida por via subcutânea. Mais estudos são necessários para avaliar a segurança e a viabilidade técnica na administração dos anticonvulsivantes de nova geração no doente paliativo por vias alternativas à oral.