Institution
Ochsner Medical Center
Healthcare•New Orleans, Louisiana, United States•
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.
Papers published on a yearly basis
Papers
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01 Jan 2018TL;DR: Perioperative care should involve a comprehensive evaluation of the patient, risk assessment of various complications, suggesting ways to reduce the complications, working on optimization of the customer’s chronic medical conditions and managing them through the perioperative period.
Abstract: Perioperative care should involve a comprehensive evaluation of the patient, risk assessment of various complications, suggesting ways to reduce the complications, working on optimization of the patient’s chronic medical conditions and managing them through the perioperative period. Hospitalists have an important role to play as medical consultants in the perioperative period.
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TL;DR: Reviewing antibiotic prescribing patterns in 75 patients admitted to multidisciplinary general medicine teaching services with a suspected diagnosis of COPD at 2 large academic health centers concluded that antibiotic stewardship and clinical pharmacists can play a key role in assisting and educating providers on the appropriate use of antibiotics in this patient population.
Abstract: The adverse effects and antimicrobial resistance associated with antibiotic use are a growing concern. In the United States, more than 140,000 emergency department visits annually are due to antibiotic-related adverse events, and antibiotic resistance is responsible for estimated health care costs of $55 billion.1,2 Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the United States.3 Exacerbations are associated with significant morbidity, mortality, and health care costs.4 Respiratory tract infections are one of the most common causes of acute exacerbations of COPD (AECOPD). As a result, the use of antibiotic therapy has become commonplace in the management of acute exacerbations. Guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) currently recommend the use of antibiotics when all the following 3 cardinal symptoms are present: increased sputum purulence, increased sputum production, and dyspnea. In addition, antibiotics are recommended in those patients with increased sputum purulence and either increased dyspnea or sputum volume. The guidelines further state that antibiotics should be selected based on local resistance patterns and recommend treatment with 5–7 days of therapy.5 These recommendations stem from several studies demonstrating a potential reduction in short-term mortality on antibiotic administration. In addition, antibiotics may reduce the incidence of treatment failure. However, many of these studies included patients with acute bronchitis, did not have a placebo control arm, or lacked imaging data to assess other respiratory infections.5 A recent study demonstrated that doxycycline did not prolong the time to recurrent exacerbation in patients treated for an AECOPD in the outpatient setting.6 As a result, the use of appropriate antibiotic therapy in outpatients has been called into question as the rates of antibiotic resistance continue to rise. The true benefit of antibiotics for patients admitted to the hospital remains less clear. Because of these questions and concerns, antibiotic stewardship and clinical pharmacists can play a key role in assisting and educating providers on the appropriate use of antibiotics in this patient population. We recently reviewed antibiotic prescribing patterns in 75 patients admitted to multidisciplinary general medicine teaching services with a suspected diagnosis of COPD at 2 large academic health centers from January 1 through July 2016 (Table 1). The most common presenting symptom was dyspnea, present in 71 patients (94.7%). Importantly, only 14 patients (18.7%) experienced all 3 cardinal symptoms or increased sputum purulence plus 1 additional cardinal symptom at presentation. Although only 18.7% of the patients met the GOLD criteria for antibiotics, 70 patients (93.3%) received antibiotic therapy for a median duration of 5.0 days (Table 2). The overall rate of appropriate antibiotic use was 25%: 14 patients met the GOLD guideline criteria for antibiotics and received antibiotics, whereas 5 patients did not meet the criteria, and antibiotics were withheld. Fifty-six patients (75%) did not meet the GOLD guideline criteria to receive antibiotics; however, all 56 patients received antibiotics. The most commonly used antibiotics were a respiratory fluoroquinolone (FQ) (levofloxacin or moxifloxacin, 58.7%) or azithromycin (34.7%). Forty-six patients (61.3%) continued antibiotics at discharge. A total of 28 patients underwent testing with a respiratory viral panel (RVP); 10 of which tested positive. Of the 10 patients with positive RVP results, all were treated with Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL; Department of Pharmacy, Ochsner Medical Center, New Orleans, LA; and Department of Community Health and Family Medicine, University of Florida College of Medicine, Gainesville, FL. The authors have no conflicts of interest to declare. *Address for correspondence: 7918 SW 82nd Drive, Gainesville, FL 32608. E-mail: ead1129@ufl.edu American Journal of Therapeutics 26, e499–e501 (2019)
1 citations
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TL;DR: The article “Combination Glucose-Lowering Therapy Plans in T2DM: Case-Based Considerations” indicates that case-based considerations should be considered for combination glucose lowering therapy plans.
Abstract: The article "Combination Glucose-Lowering Therapy Plans in T2DM: Case-Based Considerations".
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TL;DR: Obese patients require similar median argatroban maintenance doses when compared to non-obese patients and should be dosed using actual body weight regardless of BMI, according to these results.
1 citations
Authors
Showing all 993 results
Name | H-index | Papers | Citations |
---|---|---|---|
Carl J. Lavie | 106 | 1135 | 49318 |
Michael R. Jaff | 82 | 442 | 28891 |
Michael F. O'Rourke | 81 | 451 | 35355 |
Mandeep R. Mehra | 80 | 644 | 31939 |
Richard V. Milani | 80 | 454 | 23410 |
Christopher J. White | 77 | 621 | 25767 |
Bruce A. Reitz | 74 | 333 | 18457 |
Robert C. Bourge | 69 | 273 | 24397 |
Sana M. Al-Khatib | 69 | 377 | 17370 |
Hector O. Ventura | 66 | 478 | 16379 |
Andrew Mason | 63 | 360 | 15198 |
Aaron S. Dumont | 60 | 386 | 13020 |
Philip J. Kadowitz | 55 | 379 | 11951 |
David W. Dunn | 54 | 195 | 8999 |
Lydia A. Bazzano | 51 | 267 | 13581 |