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.

Medicine in Society Health Project: Five Students' Journey to a Resource-Limited Clinic in the Haitian Countryside.

Abstract: Background: Five medical students traveled with 4 doctors and a medical photographer to Mayaya, La Victoire, Haiti, as part of a Medicine in Society rotation to provide medical care to the indigenous population. Methods: Preparation for the trip involved special study in identifying microbes and using blood analysis equipment; work in a clinic for underserved people in the New Orleans, LA, area; background reading; Haitian dialect classes; and development of ideas for streamlining clinic operations. Results: During the week in country, the healthcare team saw 472 patients and made more than 1,100 diagnoses. A shortage in almost all needed medications was one of the biggest challenges. Conclusion: Each aspect of the pretrip training was useful but did not prepare the students for the conditions in the poorest country in the Western Hemisphere. Overall, the clinic functioned smoothly, and each student had an important role to play each day. Medicine in Society-Haiti gave the medical students a completely new perspective on medicine as they experienced firsthand the ethical dilemma of resource scarcity.

Renal Medullary Carcinoma

Abstract: Renal medullary carcinoma (RMC) is a rare and aggressive form of non-clear cell kidney cancer that typically affects young adults and is almost exclusively associated with sickle cell trait. It has only been recognized in the last two decades and continues to be relatively poorly understood. Patients typically present with pain and hematuria and are often found to have metastatic disease at diagnosis. Prognosis is extremely poor, with a mean survival less than 1 year. Combination chemotherapy has been used with limited success. As we learn more about the genetics of the disease, targeted therapy is being attempted.

Dinutuximab and Panobinostat.

Abstract: *Dr. Chasick is a Clinical Pharmacy Specialist for Oncology and Bone Marrow Transplant at Ochsner Medical Center in New Orleans, Louisiana. The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.

Which Is the Better Predictor of Hepatic Reserve Prior to Liver Resection: MELD or the Child-Pugh Score?

Abstract: Critical assessment of the hepatic reserve is essential prior to liver resection especially in patients with chronic liver disease. Development of liver dysfunction post resection can result in a significant increase in associated complications resulting in prolonged length of hospital stay and increased hospital costs. In addition, the development of liver failure is almost universally fatal unless the patient can undergo liver transplantation. Several scoring systems have been identified which assess the degree of liver disease including the Child-Turcotte-Pugh scoring system (CTP) and the Model for End Stage Liver Disease (MELD). Both of these scoring systems have been used to predict mortality post liver resection. Based on the current available literature, MELD appears to be the best predictor of postoperative liver dysfunction/failure in patients with cirrhosis, and patients with MELD scores ≥9 should not be considered for hepatic resection. Other factors not included in MELD such as platelet count, presence of portal hypertension, extent of liver resection (and the resulting residual liver volume) and the presence of ascites should also be considered when selecting patients with chronic liver disease to undergo liver resection.