Ochsner Medical Center

About: Ochsner Medical Center is a healthcare organization based out in New Orleans, Louisiana, United States. It is known for research contribution in the topics: Population & Heart failure. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.

Catheter-based Minimally Invasive Evacuation of Extensive Spinal Epidural Abscess: A Technical Report.

Abstract: Surgical treatment of extensive spinal epidural abscess (SEA) usually involves multilevel exposure of the dural sac with subsequent risk for iatrogenic instability. A minimally invasive technique using an epidural catheter inserted through a limited approach for distant irrigation and drainage of the abscess represents an interesting alternative. Most described techniques involve blind placement of the catheters, with the potential risk of damage to the spinal cord and incomplete abscess drainage. We present and analyze a new technique used in two cases of SEA. Those were successfully treated using a minimally invasive approach supplemented with fluoroscopically-guided catheter drainage. We suggest that fluoroscopic placement of the catheter is a safe and effective method that offers a more focused and potentially safer way to proceed to this technique.

An uncommon cause of pacemaker-mediated ventricular tachycardia.

Abstract: Telemetry revealed sinus rhythm with demand atrial pacing. As shown in Figure 1, there were frequent ventricular premature contractions and many episodes of nonsustained polymorphic ventricular tachycardia (PMVT). The device’s stored intracardiac electrograms (Fig. 2) corroborated these events. Serum levels of potassium and magnesium were normal. The 12-lead ECG during sinus rhythm showed a QTc of 462 ms. What was the cause of these episodes?

Big topics for diabetes care in 2018: Clinical guidelines, costs of diabetes, and information technology

Abstract: Diabetes Care ’s editorial committee customarily presents a midyear report of activities and progress. At the midpoint of 2018 we can describe, in addition to a satisfying array of original scientific reports, important feature articles of current interest and a significant new initiative. In the first half of this year, the journal published several feature articles related to our core responsibility as a journal representing the American Diabetes Association (ADA). An update to the ADA’s “Standards of Medical Care in Diabetes” (Standards of Care [SOC]) appeared as a supplement to the January issue (1). The SOC is prepared by the Professional Practice Committee of the ADA and contains guidance on various aspects of care of those with or at risk for diabetes, together with summaries of published data supporting these statements. Because scientific information is accumulating faster than ever before, the ADA announced a new policy in the March 2018 issue (2). The yearly January supplement to Diabetes Care will continue as before, but the SOC will now be updated more frequently. The ADA now uses a web annotation tool to update and revise the online version throughout the year, whenever new evidence or regulatory changes merit immediate incorporation. Already in 2018 new information has been added regarding two medications recently approved by the U.S. Food and Drug Administration (semaglutide and ertugliflozin) and an update on the definitions of hypoglycemia. Changes of this kind will be communicated by the ADA through its print, online, and social media channels. Additional consensus statements and commentaries on new or controversial topics will continue to appear in Diabetes Care . Unlike the SOC, they are not official guidance statements but generally reflect the ADA’s thinking. For example, a joint statement by representatives of the ADA and the European Association for the Study of Diabetes …

Effectiveness of combination endoscopic therapy for colonic anastomotic leaks

Abstract: Background Colonic anastomotic leaks are associated with significant morbidity and mortality. Whereas small case series suggest that fully covered self-expandable metal stents (FCSEMS) are effective, no larger studies have examined the impact of combination endoscopic therapy on colonic anastomotic leaks. Methods Our retrospective cohort study reviewed 51 patients undergoing endoscopic therapy for colonic anastomotic leaks between 2011 and 2018. Patients receiving combination therapy involving FCSEMS plus local closure (n = 24) were compared with patients receiving FCSEMS alone (n = 18) or endoscopic suturing alone (n = 9). The primary outcomes were technical and clinical success (resolution of leak, removal of percutaneous drains, avoidance of surgical reoperation, and reversal of temporary diversion). Results Clinical success was achieved in 55 % of patients. Clinical success was achieved in 18/24 patients (75 %) with combination therapy compared with 6/18 patients receiving FCSEMS alone (33 %, adjusted risk ratio [RR] 2.16, 95 % confidence interval [CI] 1.10 – 4.24; P = 0.02) and 4 /9 patients undergoing endoscopic suturing alone (44 %, RR 1.91, 95 %CI 0.84 – 4.31; P = 0.10). Stent migration occurred in 40 % of patients. Conclusions This large series demonstrates that combination therapy was associated with a higher rate of clinical success, and future prospective studies are warranted.