This issue of The Ochsner Journal includes a variety of topics, including clinical challenges, a summary of lessons learned for better disaster preparedness from our experience with Hurricane Katrina, a related book review on disaster planning, case reports, published works of Ochsner investigators, and the abstracts presented at Ochsner's 6th Annual Research Night.
The first two articles in the issue address clinical challenges encountered in medical practice: heart failure and ingestion of caustic substances. In the first article, Dr. Crespo and his collaborators describe their approach to defining a better prognostic indicator of outcome and to risk-stratifying patients with systolic heart failure. A review of studies conducted to date suggests that lean body mass-corrected cardiopulmonary variables may yield more accurate prognostic stratification in patients with heart failure, particularly the obese. In the second article, ingestion of caustic substances—a serious medical problem complicated by the variety of clinical presentations and the often-unpredictable clinical course of even low-grade injuries—is described. Specifically, Dr. Lupa and colleagues provide an important literature review, including a case example highlighting the challenges in diagnosing and treating caustic ingestion.
As the Gulf Coast and surrounding areas are now in the midst of the fourth post-Katrina hurricane season, healthcare providers are urged to reflect on the lessons learned from the nation's worst natural disaster and prepare their patients and practices in the event of another disaster. Dr. Krousel-Wood highlights key lessons learned for better disaster preparedness from the 2008 post-Katrina symposium issue of the American Journal of the Medical Sciences. Dr. Kemmerly's article follows later with a review of the book Disaster Planning for the Clinical Practice, an easy-to-read manual that outlines important steps for solo or small office physicians' clinical practices when they are faced with natural and man-made disasters.
New therapeutic approaches and case reports are presented next. An alternative method for applying a bowel clamp for ischemic preconditioning of pedicle flaps is presented by Dr. Ha and collaborators from the University of Western Australia. Case reports provide important insights into clinical challenges and often generate hypotheses leading to scientific investigation of the issue. Dr. Ardoin and colleagues present an interesting finding about rate-dependent left bundle-branch block in a 15 year old with propionic aciduria. Drs. Sisti and Prontera, colleagues at the University of Bologna in Italy, provide an intriguing case report and review of the literature that outline the therapeutic challenges of and potential opportunities for preventing osteoporosis in women treated for breast cancer.
A Guess the Case presented by Dr. Kim and his colleagues in vascular surgery describes an elderly man with persistent right lower leg and foot pain that begin acutely and with new onset of severe right calf claudication at a distance of less than 20 feet. Drs. Gerth and Richardson provide a Guess the Case from the Ochsner Archives and describe a 57-year-old man with several days of worsening abdominal cramps and pain.
The remainder of the issue is dedicated to scientific activities and scholarly works. Dr. Richard Re highlights recent research activities at Ochsner, which is followed by a listing of recently published articles from Ochsner investigators. Finally, the abstracts presented at Ochsner's Sixth Annual Research Night are provided, representing work conducted by Ochsner researchers and other collaborators over recent years: 76 original investigative works and 9 case reports. Staff physicians, residents and fellows, basic scientists, nurses, pharmacists, biostatisticians, and epidemiologists comprise our investigator pool. The original research reflects results from epidemiologic studies and clinical trials with children and adults and spans the breadth of concentrations, including cardiovascular disease, transplant, gastroenterology, infectious diseases, maternal and child health, radiology, rheumatology, ophthalmology, critical care, and cancer, to name a few. In addition, several abstracts highlight advances in nursing research, resident education, quality improvement, health services, and prevention.
The editorial board greatly appreciates the continued interest and efforts of our contributors and our readers. Please feel free to provide feedback regarding the content and opportunities for improvement. We look forward to your continued support.
- Academic Division of Ochsner Clinic Foundation
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