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.

Nurses' recognition of delirium in the hospitalized older adult.

Abstract: Background:Delirium is the most frequent complication associated withhospitalization of older adults, responsible for 17.5 millionadditionalhospitaldaysintheUnitedStateseachyear;yet,nursesfail to recognize it more than 30% of the time.Objectives:The specific aim of the study was to measure staff nurses’recognition of delirium in hospitalized older adults bycomparing nurse and expert diagnostician ratings for deliriumusing the Confusion Assessment Method (CAM).Method:This study investigated the rate of agreement/disagreementbetween researchers and a convenience sample of 167 nursescaring for 170 medical surgical patients (965 years) indetecting delirium. Paired (nurse vs researcher) CAM ratingswere completed at least every other day until either dischargeor delirium was detected by the researcher.Results:The researcher detected delirium in 7% (12/170) of patients.Nurses failed to recognize delirium 75% (9/12) of the time,with poor agreement between nurse/researcher for allobservations (. = 0.34). A generalized estimating equationlogistic regression model identified independent predictors ofnurses’ underrecognition of delirium that included increasingage and length of stay, dementia, and hypoactive delirium.Discussion:Findings provide further support for the significance of nurses’underrecognition of delirium in the hospitalized older adultwhen using the CAM. Additional research is warrantedregarding the clinical decision-making processes that nursesuse in assessing acute cognitive changes and in identifyingstrategies to improve delirium recognition.KEY WORDS:confusion, delirium, nurse recognition

Tumorigenesis and Aberrant Signaling in Transgenic Mice Expressing the Human Herpesvirus-8 K1 Gene

Abstract: BACKGROUND The K1 gene of human herpesvirus-8 (HHV-8; also known as Kaposi's sarcoma-associated herpesvirus) encodes a transmembrane signaling protein that elicits cellular activation events. To evaluate the potential role of K1 in HHV-8-associated pathogenesis, we produced transgenic mice expressing the HHV-8 K1 gene under the transcriptional control of the simian virus 40 promoter. METHODS Three independent heterozygous transgenic K1 mouse lines were generated from founder mice. Mouse splenic and thymic lymphocytes and tumor tissues were analyzed for the expression of cytokines involved in inflammatory and immune responses, including tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), basic fibroblast growth factor (bFGF), and interleukin 12 (IL-12); for the activation of the transcription factors nuclear factor-kappaB (NF-kappaB) and the B cell-specific transcription factor Oct-2; and for the activation of the Src and Syk family kinases, components of B-cell receptor-induced signal-transduction pathways. RESULTS Expression of bFGF was increased in K1-transgenic mice as compared with nontransgenic mice, whereas expression of TNF-alpha and IL-6 did not differ using reverse transcriptase-polymerase chain reaction. K1-transgenic mice showed substantially less serum IL-12 induction than did nontransgenic mice when challenged with a lipopolysaccharide. B lymphocytes from K1-transgenic mice but not from nontransgenic mice showed constitutive activation of NF-kappaB and Oct-2. K1 expression in human B lymphocytes stimulated NF-kappaB-dependent promoter activity. B lymphocytes from K1-transgenic mice also showed increased phosphorylation of Lyn, a Src family tyrosine kinase, and enhanced Lyn activity. Tumors in K1-transgenic mice showed features indicative of a spindle-cell sarcomatoid tumor and a malignant plasmablastic lymphoma. The pattern of cytokine, transcription factor, and Lyn kinase activity in the lymphoma was similar to that in B lymphocytes from K1-transgenic mice. CONCLUSION K1 may be involved in the activation of NF-kappaB signaling. The enhanced NF-kappaB activity in nonmalignant lymphocytes of K1 mice and its persistence in lymphoma tumors of these mice suggest that the K1 mouse may be a model of premalignancy.

Effects of Theophylline on Erythropoietin Production in Normal Subjects and in Patients with Erythrocytosis after Renal Transplantation

Abstract: Background. Erythrocytosis occurs in 10 to 15 percent of renal-transplant recipients, and there is in vitro evidence that the production of erythropoietin is modulated by adenosine. Methods. We prospectively evaluated the effects of theophylline, a nonselective adenosine antagonist, in eight patients with erythrocytosis after renal transplantation and in five normal controls. Results. After an eight-week course of theophylline treatment, the mean (±SEM) serum erythropoietin levels were significantly reduced in both the renal-transplant recipients (from 60±14 units per liter at base line to 9±7 units after treatment; P<0.05) and the normal subjects (from 6.9±0.8 units per liter at base line to 4.7±0.5 units per liter after treatment; P<0.05). Similarly, the hematocrits were reduced in both the transplant recipients (from 0.58±0.04 at base line to 0.46±0.03 after treatment; P<0.05) and the normal subjects (from 0.43±0.01 at base line to 0.39±0.01; P<0.05). In the renal-transplant recipients, red-ce...

Dietary Approaches to Prevent Hypertension

Abstract: Elevated blood pressure arises from a combination of environmental and genetic factors and the interactions of these factors. A substantial body of evidence from animal studies, epidemiologic studies, meta-analyses, and randomized controlled trials has demonstrated that certain dietary patterns and individual dietary elements play a prominent role in the development of hypertension. Changes in diet can lower blood pressure, prevent the development of hypertension, and reduce the risk of hypertension-related complications. Dietary strategies for the prevention of hypertension include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting an overall dietary pattern such as the DASH (Dietary Approaches to Stop Hypertension) diet or a Mediterranean diet. In order to reduce the burden of blood pressure-related complications, efforts that focus on environmental and individual behavioral changes that encourage and promote healthier food choices are warranted.

Arginine stimulates intestinal cell migration through a focal adhesion kinase dependent mechanism

Abstract: Background: l-Arginine is a nutritional supplement that may be useful for promoting intestinal repair. Arginine is metabolised by the oxidative deiminase pathway to form nitric oxide (NO) and by the arginase pathway to yield ornithine and polyamines. Aims: To determine if arginine stimulates restitution via activation of NO synthesis and/or polyamine synthesis. Methods: We determined the effects of arginine on cultured intestinal cell migration, NO production, polyamine levels, and activation of focal adhesion kinase, a key mediator of cell migration. Results: Arginine increased the rate of cell migration in a dose dependent biphasic manner, and was additive with bovine serum concentrate (BSC). Arginine and an NO donor activated focal adhesion kinase (a tyrosine kinase which localises to cell matrix contacts and mediates β1 integrin signalling) after wounding. Arginine stimulated cell migration was dependent on focal adhesion kinase (FAK) signalling, as demonstrated using adenovirus mediated transfection with a kinase negative mutant of FAK. Arginine stimulated migration was dependent on NO production and was blocked by NO synthase inhibitors. Arginine dependent migration required synthesis of polyamines but elevating extracellular arginine concentration above 0.4 mM did not enhance cellular polyamine levels. Conclusions: These results showed that l-arginine stimulates cell migration through NO and FAK dependent pathways and that combination therapy with arginine and BSC may enhance intestinal restitution via separate and convergent pathways.