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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Apr 18

Our question: Can a longitudinal model of specialty aligned inpatient palliative care get more patients happier and healthier to and through transplant 🤔? We will know more at the end of our trial!

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Apr 18

Today we enrolled our 100th patient into our LiverPal RCT assessing whether longitudinal inpatient palliative care can improve outcomes for hospitalized patients with liver disease and their families. What a Good Friday! #palliativehepatology #livertwitter #liversky

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Reposted by Nneka Ufere, MD MSCE

Malinda Lo @malindalo.bsky.social · Apr 14

Harvard redid its whole homepage to push back against the administration’s demands. I mean, this is just a website but I think it’s kind of a great PR move: www.harvard.edu

Harvard University

Harvard University is devoted to excellence in teaching, learning, and research, and to developing leaders who make a difference globally.

www.harvard.edu

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Reposted by Nneka Ufere, MD MSCE

Emily Moin @emilymoin.com · Apr 14

How many hospitalized patients need care in the ICU? How many of them survive? What interventions do they receive there?

These are some of the questions I had two years ago while trying to write the "background" section for my masters thesis. But I couldn't find the answers... they did not exist.

JAMA @jama.com · Apr 14

Following pandemic-era changes, many ICU outcome measures returned to prior levels.

The rates of mechanical ventilation have declined even further, while vasopressor use remained elevated above 2010s rates.

#MedSky https://ja.ma/42Jl3NO

Life Support and Outcomes Among ICU Patients

This cohort study uses data from US health systems continuously contributing to the Epic Cosmos database from 2014-2023 to characterize changes in intensive care unit (ICU) outcomes (ICU length of stay; use of mechanical ventilation or vasopressors; in-hospital mortality) and use of life support...

ja.ma

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Jan 23

As hepatologists, there are few things more devastating and very preventable that we see than HBV reactivation. If you are about to start your patient on an immunosuppressant, please keep this figure in mind. #LiverSky #MedSky

https://buff.ly/4gaKqf7

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Jan 21

Devastating read. #medsky

jamanetwork.com/journals/jam...

A Call for Mental Health Reform in Medical Education—Breaking the Silence

This essay by parents of a medical student who died by suicide calls for medical schools to better address the pressures of medical training and prevent suicide, burnout, and mental stress among healt...

jamanetwork.com

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Reposted by Nneka Ufere, MD MSCE

Elliot Tapper @ebtapper.bsky.social · Jan 17

#liversky

Guys. Rifaximin

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Reposted by Nneka Ufere, MD MSCE

Juan Turnes @jturnes.bsky.social · Jan 4

Albumin is the closest thing to a "universal remedy" in cirrhosis

We use it to treat different complications, with good evidence but also with debatable or negative evidence

Excellent analysis by Jonel Trebicka & @ggarciatsao.bsky.social

doi.org/10.1097/hep.0000000000000521

#LiverSky

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Jan 3

Just created a document titled "R01 SA page".

So it begins. Both nervous but also really excited to think big.

Advice, thoughts, prayers, etc. welcome!

#LiverSky

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 30

God bless you and this program. Seriously. Thank you for the work you do.

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 29

Amongst the palliative care domains, it feels like the domain of moral/existential/spiritual needs often gets short shrift unless patients are truly end of life. I wonder if inverting this pyramid to make existential needs the base, and not the peak, opens up a wider world of therapeutic support?

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 29

In a space in which serious illness, psychological distress, and often addiction can so closely overlap, we have found that using a moral/existential/spiritual frame in serious illness convos and exploring coping is an almost necessary consideration: “How to live a better life with liver disease”

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 29

I enjoyed reading this - thank you. I’ve been thinking about coping a lot in context of serious illness conversations in hepatology/transplant. In our inpatient LiverPal work, our team talks about how our therapeutic alliance often starts with exploring our patients’ existential/spiritual distress.

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Reposted by Nneka Ufere, MD MSCE

JAMES HEATHERS @jamesheathers.bsky.social · Dec 25

“A donor wanted to give $2 million to my lab, but only wanted to allow a maximum 10 percent to go to indirect cost recovery. And the school declined to receive the $2 million because they wanted at minimum, I believe it was 20 percent.”

www.harvardmagazine.com/2025/01/harv...

Harvard Professors Leaving for Private Sector Research | Harvard Magazine

Three distinguished scientists on leaving academia to advance biomedical research

www.harvardmagazine.com

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

Lets invest in true collaborative care with our palliative care colleagues-this is more than just a triggered referral. Working with my #LiverPal team has been the biggest professional joy of my life. Doing so has required YEARS of longitudinal teamwork and culture change. But its been so worth it.

Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

We also need to invest in bidirectional collaboration to grow specialty-aligned palliative care and support our PC clinicians in learning disease-specific symptoms, common treatments, and complications that impact prognosis and outcomes of our patients @releiter.bsky.social

https://buff.ly/3Bw36Yu

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

Authors: "A multipronged effort is needed to meaningfully move the needle...detailed measurement of individual physical, psychological, sociocultural, and other palliative care needs instead of using screening tools that merely identify these unmet domains of needs at a superficial level."

PREACH

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

We need population-specific approaches to symptom management, serious illness conversations, end-of-life care. This requires foundational research. We need to ensure that outcomes that are so often used in PallOnc interventions are appropriate, responsive, and valid in non-cancer populations.

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

And not just ICU but also inpatient/outpatient PC interventions as well. I might go further and say that the copy-and-paste approach from PallOnc trials may not only show no benefit but may have the capacity to cause harm (extra burden of visits, care not aligned with population-specific needs)

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

Thus I could not agree more with the authors: "A heterogeneous array of interventions and outcomes founded on cancer-based models of palliative care (regardless of how they are tailored or targeted) may offer limited benefit above what contemporary ICU care can deliver to patients and families."

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

As a hepatologist who is a proud member of a palliative oncology research lab I'm both inspired by my mentors but have also had a deep realization for years that a "copy-and-paste" approach using PC models developed in cancer cannot, will not, and should not be the way to build #palliativehepatology

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Nneka Ufere, MD MSCE @nnekauferemd.bsky.social · Dec 17

It is rare that an editorial will make me give a standing ovation to the authors - this one recently published in JAMA Internal Medicine by Kieran Quinn and colleagues did: https://buff.ly/4ggq9FS

@kencovinsky.bsky.social

#palliativehepatology #liversky #hapc

buff.ly

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Reposted by Nneka Ufere, MD MSCE

Catherine Mezzacappa @mezzc.bsky.social · Dec 16

How do we apply the new SLD definitions in research? To study outcomes and implement trials for different SLD subtypes, we first need to be able to accurately identify each clinical entity using medical records/registry data.
www.cghjournal.org/article/S154...

@amergastroassn.bsky.social

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Reposted by Nneka Ufere, MD MSCE

Journal of Palliative Medicine @j-palliativemed.bsky.social · Dec 13

@j-palliativemed.bsky.social Daniel Shalev et al respond to Susan Block's Special Report: Realizing the Imperative: The Future of Mental Health and Palliative Care Integration www.liebertpub.com/doi/10.1089/...

Realizing the Imperative: The Future of Mental Health and Palliative Care Integration | Journal of Palliative Medicine

Journal of Palliative Medicine

www.liebertpub.com

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Reposted by Nneka Ufere, MD MSCE

Elliot Tapper @ebtapper.bsky.social · Dec 16

Everything you want to know about the management of depression and anxiety in #cirrhosis

From Zimbrean (@YalePsych) and Jakab (@YaleDigestive)

journals.lww.com/hepcomm/full...
#liversky

Depression and anxiety management in cirrhosis : Hepatology Communications

nd depression are linked to lower health-related quality of life, more severe symptoms (eg, fatigue), and poorer response to medical treatment. Screening instruments for depression and anxiety have sh...

journals.lww.com

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