From The Editor's Desk

I take particular pride in presenting this issue of The Ochsner Journal to you because it demonstrates the diverse clinical, educational, and research interests that have evolved at Ochsner Clinic and Alton Ochsner Medical Foundation.

Drs. Schorin and Ducos of the Pediatric Hematology-Oncology Section initiate our eighth issue by discussing their 17-year experience with acute lymphoblastic leukemia in childhood. The clinical trials that the authors have conducted have led to improved means of healthcare delivery and provided results that parallel those observed at the renowned Dana Farber Cancer Institute. The authors are to be congratulated on their success.

Many of us are aware of the high-profile coronary risk factors such as smoking, obesity, and hypertension, but how many of us are aware that there may be an added risk from chlamydia, cytomegalovirus, and Helicobacter pylori infections? Dr. Harjai of the Cardiology Department discusses current thinking about the potential role that these infections and other less conventional risk factors play. As a gastroenterologist, the Helicobacter organism has already gained my respect as a miserable little bug and a source of untold misery. If these and other putative risk factors are clearly shown to have a link to coronary artery disease risk, it could have a profound effect on prevention strategies for coronary artery disease in the future.

I must admit that I was more than a bit amused when I read the subtitle of the article by Richard Chambers, PhD: “Research Without Patients?” Let the truth be known, however, that this is not only possible but an important field. For example, in my area of research interest, antiviral therapy of chronic viral hepatitis, the Markov model that Dr. Chambers discusses has rapidly become the major yardstick by which we assess cost-effectiveness, impact of treatment on quality of life, and what life-year gains are made by early treatment of this disorder.

Dr. Sandy Kemmerly of the Section on Infectious Diseases then discusses an age-old malady, influenza, and brings us up to date on prevention strategies. The message of her article is clear: vaccinate, vaccinate, vaccinate! It has been said that we live in a treatment orientated (rather than prevention minded) society. However, it is quite clear from her article that it is far easier and more effective to vaccinate than it is to treat this very common condition. In this regard, it is instructive to look at the updated listing of indications for flu vaccination by the Centers for Disease Control that Dr. Kemmerly has included.

One of the ways of meeting head on the changes invoked by managed care is to train physicians more broadly in the areas of Internal Medicine and Family Practice. Alton Ochsner Medical Foundation initiated our combined Family Practice and Internal Medicine Residency Program in 1995 and was one of the first in the nation to be approved by the respective specialty boards. As pointed out in the article by Drs. Murphree and Brandon of the Departments of Internal Medicine and Family Medicine, the Ochsner program has consistently matched with our highest ranked students over each year of the program despite a marked decline in US graduates entering primary care fields. The authors provide a description of the curriculum and the encouraging results of a resident based survey.

Finally, Dr. Richard Re, Vice President and Director of Research, discusses the application of antisense technology to medicine. There is a vast amount of information and clinical therapeutic potential of this molecular technique, which in the field of gastroenterology alone has been applied to disorders as different as viral hepatitis and inflammatory bowel disease. I think you will find his explanations of antisense technology to be both lucid and fascinating.

As always, we enjoy bringing you a look at the various areas of interest of the staff of Ochsner Clinic and Alton Ochsner Medical Foundation, and we welcome any comments that you have on areas about which you would like to learn more