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Godfrey S, Peng Y, Lorusso N, Sulistio M, Mentz RJ, Pandey A, Warraich H. Palliative Care for Patients With Heart Failure With Preserved Ejection Fraction. Circ Heart Fail 2023; 16:e010802. [PMID: 37869880 DOI: 10.1161/circheartfailure.123.010802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/31/2023] [Indexed: 10/24/2023]
Abstract
Heart failure with preserved ejection fraction (HFpEF) has become the leading form of heart failure worldwide, particularly among elderly patient populations. HFpEF is associated with significant morbidity and mortality that may benefit from incorporation of palliative care (PC). Patients with HFpEF have similarly high mortality rates to patients with heart failure with reduced ejection fraction. PC trials for heart failure have shown improvement in quality of life, quality of death, and health care utilization, although most trials defined heart failure clinically without differentiating between HFpEF and heart failure with reduced ejection fraction. As such, the timing and role of PC for HFpEF care remains uncertain, and PC referral rates for HFpEF are very low despite potential improvements in important patient-centered outcomes. Specific barriers to referral include limited data, prognostic uncertainty, provider misconceptions about PC, inadequate specialty PC workforce, complexities of treating multimorbidity, and limited home care options for patients with heart failure. While there are many barriers to integration of PC into HFpEF care, there are multiple potential benefits to patients with HFpEF throughout their disease course. As this population continues to grow, targeted efforts to study and implement PC interventions are needed to improve patient quality of life and death.
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Affiliation(s)
- Sarah Godfrey
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.G., M.S., A.P.)
| | | | - Nicholas Lorusso
- Department of Natural Sciences, University of North Texas at Dallas (N.L.)
| | - Melanie Sulistio
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.G., M.S., A.P.)
| | - Robert J Mentz
- Duke University Medical Center, Division of Cardiology, Durham, NC (R.J.M.)
| | - Ambarish Pandey
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.G., M.S., A.P.)
| | - Haider Warraich
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA (H.W.)
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Abousaab C, Chen C, Suarez A, Berlacher M, Newcomer K, Griffith P, Sulistio M. Charging…Everybody Clear?: A Look at Accessibility of Content in Implantable Cardioverter Defibrillator Patient Resources. Am J Med Sci 2022; 364:124-126. [DOI: 10.1016/j.amjms.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/29/2021] [Accepted: 01/31/2022] [Indexed: 11/01/2022]
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Weis JJ, Hogg DC, Sulistio M, Farr DE, Ginsburg C, Guttman OT, Krumwiede KH, Kho KA, Martinez J, Reed G, Rege RV, Thiele D, Wagner JM, Scott DJ. Assessing quality and resources during campus-wide simulation integration. Am J Surg 2019; 219:33-37. [PMID: 30898304 DOI: 10.1016/j.amjsurg.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/20/2019] [Accepted: 03/06/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Our simulation center, supported by four departments (Surgery, OB/GYN, Urology, and Anesthesiology), is accredited as a comprehensive Accredited Educational Institute (AEI) and is now expanding to accommodate all departments on campus. METHODS A 61-point questionnaire was administered to 44 stakeholders, representing all of UME and GME. Data were compared for AEI vs. non-AEI activities. RESULTS Responses were collected from all 44 groups (100% response rate). Overall, 43 simulation activities were hosted within the AEI and 40 were hosted by non-AEI stakeholders. AEI activities were more likely to be mandatory (93% vs. 75%, p = 0.02), have written learning objectives (79% vs 43%, p < 0.001), and use validated assessment metrics (33% vs. 13%, p = 0.03). CONCLUSION These data suggest that the AEI courses are more robust in terms of structured learning and assessment compared to non-AEI courses. Campus-wide application of uniform quality standards is anticipated to require significant faculty, course, and program development.
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Affiliation(s)
- Joshua J Weis
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Deborah C Hogg
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Melanie Sulistio
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Deborah E Farr
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Charles Ginsburg
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Oren T Guttman
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | - Kimberly A Kho
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Joseph Martinez
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Gary Reed
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Robert V Rege
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Dwain Thiele
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - James M Wagner
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Daniel J Scott
- UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA
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Daniel M, Sulistio M, Koshy T, Luna M, Khera A, Ayers C. PRE-CARDIAC CATHETERIZATION SIMULATION TRAINING IN CARDIOVASCULAR FELLOWSHIP: OUTCOMES OVER TWO YEARS. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)33197-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
BACKGROUND Near-peer teaching is effective in graduate medical education, but it has not been compared with faculty member teaching in resident simulation. In this study, we sought to compare debriefing sessions of internal medicine (IM) intern simulation sessions led by academic faculty doctors with those led by senior IM residents in order to measure the effectiveness of near-peer teaching in this setting. Near-peer teaching is effective in graduate medical education, but has not been compared with faculty member teaching in resident simulation METHOD: Internal medicine interns participated in four simulation cases, two of which were debriefed by faculty members and two of which were debriefed by residents. Pre-simulation knowledge assessment was completed prior to the case. Following each debriefing, interns completed a Debriefing Assessment for Simulation in Healthcare (DASH) survey. Post-simulation knowledge assessments were completed 6 months after simulation. Debriefings were recorded and transcribed. Each statement made during debriefing was classified as either correct or erroneous by blinded reviewers. RESULTS Fifty interns participated in simulation, and the response rate on the DASH survey was 88%. There was no difference between DASH scores (p = 0.13), post-simulation knowledge assessments or error rates during debriefing (p = 0.31) for faculty member and resident instructors. CONCLUSION Our study suggests that residents and faculty members provide a similar quality of simulation instruction based on qualitative and quantitative evaluation.
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Affiliation(s)
- Traci Adams
- Department of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chad Newton
- Department of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hetal Patel
- Department of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Melanie Sulistio
- Department of Cardiology, University of Texas Southwestern Medical Centre, Dallas, Texas, USA
| | - Andrew Tomlinson
- Department of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Won Lee
- Department of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Sulistio M, Vo A, Franco M. TO MET OR NOT TO MET: THAT IS THE QUESTION!:. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sulistio M, Carothers C, Mangat M, Lujan M, Oliveros R, Chilton R. GLP-1 agonist-based therapies: an emerging new class of antidiabetic drug with potential cardioprotective effects. Curr Atheroscler Rep 2009; 11:93-9. [PMID: 19228481 DOI: 10.1007/s11883-009-0015-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cardiovascular disease is a leading cause of death in the United States and across the world, and better therapies are constantly being sought to improve patient outcomes. Recent studies have brought our attention to the mechanisms of glucagon-like peptide 1 (GLP-1). Not only does it demonstrate beneficial effects in regard to cardiovascular risk factors (i.e., diabetes, lipid management, and weight control), but it also has been shown in animal studies to have positive cardiac effects irrespective of its effects on glucose control and weight loss. This review discusses the biology of GLP-1 and its effects on cardiovascular risk factors, and it also elaborates on the positive direct cardiovascular outcomes of GLP-1 in animal studies.
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Affiliation(s)
- Melanie Sulistio
- University of Texas Health Science Center, 27971 Smithson Valley, San Antonio, TX 78261, USA
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