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 & Medicine. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.

Cardiac Defibrillators and Heart Failure

Abstract: Congestive heart failure affects over five million people in the United States with over 500,000 new cases reported annually. Roughly half of patients die from heart failure related causes within the first 5 years of diagnosis. Conventional medical therapy including beta blockers, renin-angiotensin antagonists and aldosterone antagonists has improved morbidity and mortality in this population. However Sudden Cardiac Death (SCD) remains the leading cause of death in this group of patients. Implantable Cardioverter-Defibrillators (ICDs) were initially used to prevent future arrhythmic deaths in patients who survived SCD. Utilization of ICDs was greatly expanded when landmark clinical trials demonstrated that ICDs reduce mortality, particularly due to arrhythmic events, in heart failure patients. In addition to conventional medical therapy, ICD implantation has become the standard of care in patients with reduced ejection fraction, no matter the etiology of their heart failure.

Lateral Lumbar Interbody Fusion (LLIF) for the Treatment of Adult Spinal Deformity (ASD)

Abstract: Adult scoliosis (AS) may be defined as a coronal deformity with a Cobb angle >10° in a skeletally mature patient. Although AS can develop from the progression of idiopathic scoliosis (IS) in adolescence, more commonly AS develops as the result of a degenerative cascade later in life that terminates in asymmetric disc collapse, vertebral body wedging, facet degeneration, spondylolisthesis, and rotary subluxation. This degenerative cascade has the potential to lead to spinal stenosis, instability with progressive deformity in the coronal and sagittal planes, loss of lumbar lordosis, and the development of sagittal imbalance. Patient symptoms can include radiculopathy, neurogenic claudication, and back pain [1].

Utility of serial measurement of biomarkers of cardiovascular stress and inflammation in systolic dysfunction.

Abstract: Evidence links markers of systemic inflammation and heart failure (HF) with ventricular arrhythmias (VA) and/or death. Biomarker levels, and the risk they indicate, may vary over time. We evaluated the utility of serial laboratory measurements of inflammatory biomarkers and HF, using time-dependent analysis. We prospectively enrolled ambulatory patients with left ventricular ejection fraction (LVEF) ≤35% and a primary-prevention implanted cardioverter-defibrillator (ICD). Levels of established inflammatory biomarkers [C-reactive protein, erythrocyte sedimentation rate (ESR), suppression of tumourigenicity 2 (ST2), tumour necrosis factor alpha (TNF-α)] and brain natriuretic peptide (BNP) were assessed at 3-month intervals for 1 year. We assessed relationships between biomarkers modelled as time-dependent variables, VA, and death. Among 196 patients (66±14 years, LVEF 23±8%), 33 experienced VA, and 18 died. Using only baseline values, BNP predicted VA, and both BNP and ST2 predicted death. Using serial measurements at 3-month intervals, time-varying BNP independently predicted VA, and time-varying ST2 independently predicted death. C-statistic analysis revealed no significant benefit to repeated testing compared with baseline-only measurement. C-reactive protein, ESR, and TNF-α, either at baseline or over time, did not predict either endpoint. In stable ambulatory patients with systolic cardiomyopathy and an ICD, BNP predicts ventricular tachyarrhythmia, and ST2 predicts death. Repeated laboratory measurements over a year's time do not improve risk stratification beyond baseline measurement alone. Clinicaltrials.gov NCT01892462 (https://clinicaltrials.gov/ct2/show/NCT01892462).

Neonate With Paraplegia

Abstract: A newborn female presented with bilateral lower limb paralysis and anuria. Physical exam was notable for a mass on the right flank as well as the previously mentioned paraplegia. No facial defects or evidence of limb deformities were present. Both the course of pregnancy and delivery were unremarkable. Ultrasound performed at 18 weeks was normal by history. Spinal magnetic resonance imaging (MRI) demonstrated a heterogeneous retroperitoneal mass. The mass was inferior to the right kidney, displacing it superiorly. Both the inferior vena cava and the aorta were displaced anteriorly. The mass extended into the right paraspinous region and spinal canal, entering at L2-3 and L3-4 right neural foramina. It extended superior to T4 and inferiorly to L5-S1. C6 enhancement may have represented skip epidural metastasis. The lesion displaced the thecal sac/spinal cord from T6-T10. T10-L2 vertebral body had no identifiable spinal cord. No other metastatic foci were detected. The newborn also had bilateral hydronephrosis, which was more extensive on the right side (see Figures 1 and 2). Bone marrow aspirate, urine vanillylmandelic acid and homovanillic acid, metaiodobenzylguanidine scan, and a bone scan were all negative. Needle biopsy of the mass was performed and neuroblastoma or other small cell tumors were considered. Slides from the needle biopsy were sent to the Mayo Clinic for review. Morphological and immunohistology studies at Mayo confirmed the diagnosis of malignant rhabdoid tumor.