Showing papers by "Ochsner Medical Center published in 2006"
TL;DR: These data demonstrate the adverse psychological and CAD risk profiles that are present in young patients with CAD following major CAD events, and are consistent with substantial benefit of formal cardiac rehabilitation and exercise training programs in younger adults.
Abstract: Background: Recent data indicate that young patients with coronary artery disease (CAD) have a poor longterm prognosis. Although the benefits of formal cardiac rehabilitation and exercise training programs are well established, most of these data come from middle-aged and older patients. Methods: We assessed baseline behavioral data, quality of life, and risk profiles in 635 consecutive patients with CAD before and after cardiac rehabilitation and exercise training, and specifically assessed data in 104 young patients (mean±SD age, 48±6 years; range, 22-54 years) compared with 260 elderly patients (mean±SD age, 75±3 years; range, 70-85 years). Results: Compared with older patients, young patients had higher body mass indexes (12.2%,P.001), total cholesterol–high-density lipoprotein ratio (14.6%, P.01), and triglycerides level (27.2%,P.01), and a lower highdensity lipoprotein cholesterol level (�8.8%, P=.045). Young patients also had higher scores for anxiety and hostility (51.5% and 94.4%, respectively; P.001 for both), a considerably higher prevalence of anxiety (27.9% vs 13.5%; P.01) and hostility (12.5% vs 4.6%; P.01) symptoms, and slightly more depression symptoms (23.1% vs 18.8%) compared with elderly patients. Following cardiac rehabilitation and exercise training, young patients had improvements in body mass index (�1.7%, P.01), percentage body fat (�4.4%, P.001), highdensity lipoprotein cholesterol level (10.2%, P.001), high-sensitivity C-reactive protein level (�33.3%,P.01), peak oxygen consumption (11.3%,P.001), resting heart rate (�4.5%,P=.01), and resting systolic pressure (�2.3%, P=.049), and marked improvements in scores for depression (�58.5%), anxiety (�46.0%), hostility (�45.7%), somatization (�33.8%), and quality of life (15.8%) (P.001 for all). Young patients also had greater than 50% to greater than 80% reductions in the prevalence of anxiety (P.001), hostility (P.01), and depression (P.001). Conclusion: These data demonstrate the adverse psychological and CAD risk profiles that are present in young patients with CAD following major CAD events, and are consistent with substantial benefit of formal cardiac rehabilitation and exercise training programs in younger adults.
174 citations
01 Dec 2006
TL;DR: This review provides basic, practical information about cardiopulmonary exercise testing for the clinician.
Abstract: Cardiopulmonary exercise testing adds important additional information to that provided by the standard exercise test. In particular, cardiopulmonary exercise testing provides precise determination of aerobic capacity, the causes of dyspnea with exertion, and prognosis in patients with systolic heart failure. This review provides basic, practical information about cardiopulmonary exercise testing for the clinician.
156 citations
TL;DR: For the first time, a drug has demonstrated significant slowing of loss in lung function, suggesting that patients kept on prolonged maintenance treatment with everolimus may benefit from replacing AZA withEverolimus 3 months after lung transplantation.
146 citations
TL;DR: The Breathsavers Group improved both clinical care processes and clinical outcomes during the Neonatal Intensive Care Quality Collaborative.
Abstract: OBJECTIVE. The objective of this study was to compare the primary and secondary outcomes of very low birth weight infants before and after participation in the Breathsavers Group of the Vermont Oxford Network–sponsored Neonatal Intensive Care Quality Collaborative. METHODS. Hospitals that participated in the Breathsavers Group contributed clinical data on the outcomes of their very low birth weight infants to the Vermont Oxford Network using standardized clinical definitions, data forms, and inclusion criteria. Outcomes from the last year of the collaborative, 2003, were compared with those from the baseline year, 2001. Models for treatment practices and outcomes measures were adjusted for within-hospital correlation (clustering) and standard risk factors that were present at birth. RESULTS. Bronchopulmonary dysplasia dropped significantly in 2003 compared with the baseline year. Survival improved but not significantly. In addition, severe retinopathy of prematurity, severe intraventricular hemorrhage, and supplemental oxygen at discharge dropped significantly. The use of conventional ventilation at any time during the initial hospitalization, postnatal steroids, and time to first dose of surfactant all decreased significantly. The use of nasal continuous positive airway pressure at any time during hospitalization increased. The use of high-frequency ventilation, delivery room intubation, and surfactant at any time during hospitalization did not change. CONCLUSIONS. The Breathsavers Group improved both clinical care processes and clinical outcomes during the Neonatal Intensive Care Quality Collaborative.
91 citations
TL;DR: It is concluded that mTOR/p70(s6k) signaling is essential to intestinal cell migration, is activated by ARG, involves both nuclear and cytoplasmic events, and may play a role in intestinal repair.
Abstract: An early signaling event activated by amino acids and growth factors in many cell types is the phosphorylation of the mammalian target of rapamycin (mTOR; FRAP), which is functionally linked to ribosomal protein s6 kinase (p70(s6k)), a kinase that plays a critical regulatory role in the translation of mRNAs and protein synthesis. We previously showed that intestinal cell migration, the initial event in epithelial restitution, is enhanced by l-arginine (ARG). In this study, we used amino acids as prototypic activators of mTOR and ARG, IGF-1, or serum as recognized stimulators of intestinal cell migration. We found that 1) protein synthesis is required for intestinal cell migration, 2) mTOR/p70(s6k) pathway inhibitors (rapamycin, wortmannin, and intracellular Ca(2+) chelation) inhibit cell migration, 3) ARG activates migration and mTOR/p70(s6k) (but not ERK-2) in migrating enterocytes, and 4) immunocytochemistry reveals abundant p70(s6k) staining in cytoplasm, whereas phospho-p70(s6k) is virtually all intranuclear in resting cells but redistributes to the periphery on activation by ARG. We conclude that mTOR/p70(s6k) signaling is essential to intestinal cell migration, is activated by ARG, involves both nuclear and cytoplasmic events, and may play a role in intestinal repair.
85 citations
TL;DR: In this paper, the prognostic impact of other LV geometric patterns, including concentric remodeling (CR), compared with LV hypertrophy has not been studied in a large cohort of older patients.
Abstract: Numerous studies have indicated that left ventricular (LV) hypertrophy predicts morbidity and mortality, including studies in older patients. The prognostic impact of other LV geometric patterns, including concentric remodeling (CR), compared with LV hypertrophy has not been studied in a large cohort of older patients. Echocardiographic and clinical data were studied in 9,771 consecutive patients aged >70 years with ejection fractions ≥50% who were followed for 3.1 years to determine the impact of LV geometric patterns. CR was the most prevalent pattern (43%), and 16% met criteria for LV hypertrophy. Although patients with CR had significantly lower LV mass indexes than patients with normal structure as well as those with LV hypertrophy, their mortality was 35% higher than that of normal subjects (15.5% vs 11.5%, p 70 years with normal systolic function, being present in 59% of this population, with CR (43%) by far the most common LV geometric pattern. Patients aged >70 years with CR have significantly increased mortality compared with similarly aged patients with either normal structure or eccentric LV hypertrophy, with similar increased mortality to those with concentric LV hypertrophy.
73 citations
TL;DR: Multiinstitutional collaboration facilitated development and implementation of potentially better practices to reduce bronchopulmonary dysplasia in very low birth weight infants.
Abstract: OBJECTIVE. The objective of this study was to describe development and implementation of potentially better practices to reduce bronchopulmonary dysplasia in very low birth weight infants (birth weight: 501–1500 g). METHODS. Results of Breathsavers Group meetings, conference calls and critically appraised topic summaries were used to construct potentially better practices. Implementation plans and experiences were reported by participants and collated. RESULTS. The Breathsavers Group developed 13 potentially better practices, based on published evidence and expert opinion. Participants determined which potentially better practices to implement and implementation methods. Participating NICUs implemented an average of 5 potentially better practices (range: 3–9). The Breathsavers Group also developed a resource kit, identified common obstacles to implementation, and initiated research to define bronchopulmonary dysplasia better. CONCLUSIONS. Multiinstitutional collaboration facilitated development and implementation of potentially better practices to reduce bronchopulmonary dysplasia.
41 citations
TL;DR: TACE expression and its activity, as measured by increases in TNF-α, TNFR1, and IL-6 levels, are increased following hepatic ischemia/reperfusion injury, implying that TACE plays an important role in hepatic Ischemia-reperFusion injury.
Abstract: Background. Tumor necrosis factor (TNF)-alpha and its receptors play a critical role in the inflammatory cascade after hepatic ischemia/reperfusion injury. TNF-alpha converting enzyme (TACE) or disintegrin and metalloproteinase (ADAM)-17 is a metalloproteinase disintegrin that specifically cleaves precursor TNF-a to its mature form and is involved in the ectodomain shedding of TNF receptors. The regulation of TACE is poorly understood and its role in liver injury and/or regeneration is unknown.
32 citations
TL;DR: Novel incretin-based therapies currently available, and in late-stage development, are among those showing the greatest promise for addressing the unmet needs of traditional therapies.
Abstract: OBJECTIVE: To review the pathophysiology of type 2 diabetes (T2DM), the role ofincretins, the potential of incretin-based therapies to address unmet therapeuticneeds in T2DM, and the potential impact this will have on the contribution of managed care pharmacy to diabetes therapy. SUMMARY: Diabetes, the fifth leading cause of death by disease in the United States, costs approximately $132 billion per year in direct and indirect medical expenses. According to the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey, a majority of diabetes patients do not achieve target A1C levels with their current treatment regimens. Advances in understanding the pathophysiologic abnormalities underlying the metabolic dysfunctions associated with T2DM are leading to the development of new treatment approaches and new therapeutic classes of drugs. Novel incretin-based therapies currently available, andin late-stage development, are among those showing the greatest promise for address...
16 citations
University of Arkansas for Medical Sciences1, Albany Medical College2, University of Texas Health Science Center at San Antonio3, Mayo Clinic4, Duke University5, University of Maryland, Baltimore6, University of Alabama at Birmingham7, Harvard University8, New York University9, University of Tennessee Health Science Center10, Long Beach Memorial Medical Center11, Ankara University12, Hacettepe University13, Roswell Park Cancer Institute14, University of Wisconsin-Madison15, University of California, Irvine16, University of Colorado Denver17, University of Southern California18, Tufts University19, Yeshiva University20, University of Mississippi21, University of Cologne22, Carlos III Health Institute23, University of Massachusetts Medical School24, University of Aberdeen25, University of Manchester26, Radboud University Nijmegen27, Université de Montréal28, Indiana University29, University of Paris30, Virginia Commonwealth University31, Texas Tech University Health Sciences Center32, Case Western Reserve University33, University of Florida34, University of Kentucky35, LSU Health Sciences Center Shreveport36, National Institutes of Health37, San Antonio Military Medical Center38, University of Pittsburgh39, City of Hope National Medical Center40, University of Miami41, St. Jude Children's Research Hospital42, University of Texas MD Anderson Cancer Center43, Karolinska Institutet44, St. Vincent's Health System45, University of Texas Medical Branch46, Federal University of Rio de Janeiro47, University of Illinois at Chicago48, Ochsner Medical Center49, University of Iowa50, Wayne State University51, McMaster University52, Charité53, University of Pennsylvania54, Georgetown University55, George Washington University56, Children's National Medical Center57, University of Cincinnati58, University of Sydney59, University of Milan60, Katholieke Universiteit Leuven61, Rowan University62
TL;DR: This paper aims to provide a history of single-cell myeloma in the clinic and some of the mechanisms leading to cell death and its Kessler’s disease progression.
Abstract: Received 6 September 2006; accepted 6 September 2006;electronically published 13 September 2006Author affiliations are listed at the end of the textReprints or correspondence: Dr Elias J Anaissie, MyelomaInstitute for Research and Therapy, University of Arkansasfor Medical Sciences, 4301 W Markham, Slot 816, LittleRock, AR 72205 (anaissieeliasj@uamsedu)
5 citations