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.

The Obesity Paradox and Cardiorespiratory Fitness

Abstract: Obesity is associated with a number of risk factors for cardiovascular diseases (CVD), such as metabolic syndrome, hyperlipidemia (HLD), glucose intolerance, and hypertension (HTN). Several studies have, however, reported that a body mass index (BMI) representing overweight and obese individuals (BMI > 25.0 kg/m2) is more protective against mortality than BMI representing normal-weight individuals (BMI 18.5–24.9 kg/m2). This association has been termed as the BMI or obesity paradox (OP). In contrast to obesity, increased cardiorespiratory fitness (CRF) is associated with lower risk for CVD. In addition, some evidence suggests that CRF may modulate the BMI-CVD association. Specifically, the increased risk observed in individuals with normal BMI levels is greatly attenuated by increased CRF, suggesting that the increased risk may be the outcome of underlying muscle-wasting disease and not low body weight per say. In this review, we discuss the effects of the OP and CRF as it pertains to morbidity/mortality and CVD, as well as the role of physical activity and CRF in modifying morbidity/mortality and CVD.

Clinical Case of the Month: A 49 Year-Old Man Who Presents with Left Sided Weakness: An Update on Ischemic Stroke.

Abstract: A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness. On initial exam, the temperature was 99°F, the pulse was 93 beats per minute, the blood pressure was 191/100 mmHg, the respiratory rate was 22 breaths per minute, and the oxygen saturation was 100% while breathing room air. His neurological exam revealed diminished strength in the left upper extremity: 4/5 arm abduction and adduction of the left shoulder; 4/5 elbow and wrist extension and flexion; and 4/5 extension, abduction, and adduction of the digits. The patient also exhibited slight left upper extremity pronator drift. The strength was also diminished in the left lower extremity: 2/5 hip flexion, extension, and rotation; 3/5 knee flexion and extension; and 3/5 ankle dorsiflexion and plantar flexion. Initial NIH stroke scale score was 5, otherwise, there were no focal neurological deficits and the remainder of his exam was unremarkable. Initial computed tomography (CT) of the head was negative for any acute intracranial hemorrhage or infarct. A subsequent CT cerebral perfusion scan (Figure 1) was notable for areas of ischemia in the right cingulate gyrus as well as the medial frontal and parietal lobes. CT angiogram of the neck revealed bilateral atherosclerotic plaque in the carotid arteries; however, there was no evidence of any flow-limiting stenosis.