Publications by authors named "Gwen Bernacki"
Article Synopsis
- Calcific aortic stenosis serves as a model for understanding cardiovascular issues in older adults, influenced by multiple factors related to aging.
- Research on transcatheter aortic valve replacement has primarily involved older patients, leading to the recognition of frailty and other geriatric risks as important for better assessing patient conditions.
- The review emphasizes the need for a comprehensive approach to diagnosis and management of aortic stenosis in older adults, advocating for improved patient engagement and identifying key areas for future research.
Article Synopsis
- Palliative care (PC) is critical for high-quality treatment of cardiovascular disease (CVD), but there's limited knowledge about its incorporation into CVD training programs.
- A survey distributed to leaders of CVD fellowships revealed that while most programs address PC annually, many expressed dissatisfaction with the quality and quantity of education provided.
- Identified barriers to effective PC education included overwhelming content demands and a lack of interest from both fellows and faculty, highlighting the need for improved training and strategies for integrating PC into curricula.
Article Synopsis
- Cardiovascular multidisciplinary heart teams (MDHTs) have greatly changed over the past decade, becoming essential in treating various heart diseases across multiple specialties.
- The structure and function of these teams have adapted to better address patient needs, but there is still a lack of established best practices for their effectiveness compared to cancer care teams.
- This expert panel review examines the history, current roles, and challenges of cardiovascular MDHTs, while highlighting the need for more evidence on their effectiveness and operational strategies.
Article Synopsis
- The study examined how TAVR programs handle patients with Do Not Resuscitate (DNR) status and whether their practices align with patient care goals.
- Interviews were conducted with TAVR coordinators from 52 programs in Washington and California, revealing that while most programs address code status during procedures, only a small fraction have formal policies in place.
- The research found significant variability in how DNR status is managed post-procedure, with some programs considering TAVR a palliative option, while others temporarily revoke DNR status, highlighting differing philosophies on patient accountability and care.
Article Synopsis
- - This study looks at how patients with kidney disease from racial and ethnic minority groups differ in their existential and supportive care needs compared to White patients.
- - The research focuses on the specific challenges and requirements these diverse groups face in managing their health and emotional well-being.
- - The findings aim to highlight disparities and improve care strategies for all patients, ensuring that everyone receives the necessary support tailored to their unique backgrounds.
Article Synopsis
- Heart failure (HF) and chronic kidney disease (CKD) together lead to higher health risks and complexity in end-of-life care compared to having only one of these conditions.
- A study analyzed end-of-life care quality using data from deceased patients, highlighting that those with both HF and CKD experienced more hospitalizations and intensive care unit admissions in their last 30 days versus those with only one condition.
- Results showed patients with both conditions had more advance care planning documentation, implying a need for improved interventions to ensure care aligns with their goals at the end of life.
Article Synopsis
- * Digital health technologies (like telehealth and remote monitoring) offer a chance to enhance healthcare access and outcomes, especially during the COVID-19 pandemic.
- * It's crucial to consider challenges faced by older adults, such as cognitive and physical limitations, to prevent widening health disparities when implementing these digital solutions.
Article Synopsis
- The study investigates whether the cardiopulmonary resuscitation (CPR) preferences of dialysis patients match their overall end-of-life care values.
- It included a survey of 876 patients from dialysis facilities in Seattle and Nashville, finding that a significant majority (84.2%) preferred CPR if their heart stopped.
- Results showed that those wanting CPR were also more likely to desire mechanical ventilation and had different engagement levels in advance care planning compared to those preferring do-not-resuscitate (DNR) options.
Article Synopsis
- The study explores clinician attitudes towards deprescribing cardiovascular medications in older adults to reduce polypharmacy risks and adverse drug events.
- Researchers conducted a national survey of geriatricians, general internists, and cardiologists, finding a significant interest in deprescribing among all specialties, with over 80% considering it recently.
- Adverse drug reactions were the primary motivator for deprescribing, with geriatricians more likely to do so in cases of limited life expectancy compared to cardiologists.
Article Synopsis
- Older patients have historically been underrepresented in clinical trials, and this study analyzed data from 76,141 patients with acute coronary syndrome to assess changes in enrollment by age from 1994 to 2010.
- The percentage of patients aged 75 and older initially increased but later declined, while the prevalence of comorbidities rose across all age groups.
- Despite a slight rise in predicted mortality rates, the actual 6-month mortality rates significantly dropped for all age groups over time due to improved evidence-based treatment practices.
Article Synopsis
- The study used PET imaging to examine how age and exercise training affect cardiac sympathetic nervous system function in healthy male and female volunteers.
- Results showed that while presynaptic uptake of norepinephrine (measured as PSnt) declined with age, no differences were found regarding postsynaptic function (β'max) across different age groups.
- After 6 months of exercise training, while participants improved their aerobic capacity (VO2 max), there were no significant changes in cardiac sympathetic function measurements, indicating that either no substantial changes occur or current imaging methods are insufficient to detect them.
Article Synopsis
- * There is an increasing demand for safe and effective treatments for AF, particularly for older adults who are at greater risk for complications.
- * The review discusses the use of oral anticoagulants in treating AF in older patients, emphasizing practical concerns such as how these drugs are processed in the body, interactions with other medications, existing health issues, and the financial aspects related to insurance and healthcare costs.