Interventions to improve adherence to lipid-lowering medication.

Background: Lipid-lowering drugs are widely underused, despite strong evidence indicating they improve cardiovascular end points. Poor patient adherence to a medication regimen can affect the success of lipid-lowering treatment.

Objectives: To assess the effects of interventions aimed at improving adherence to lipid-lowering drugs, focusing on measures of adherence and clinical outcomes.

A Metaanalysis of Interventions to Improve Adherence to Lipid-Lowering Medication.

Background: Inadequate patient adherence to a medication regimen is a major factor in the lack of success in treating hyperlipidemia. Improved adherence rates may result in significantly improved cardiovascular outcomes in populations treated with lipid-lowering therapy. The purpose of this metaanalysis was to evaluate the effectiveness of interventions aimed at improving adherence to lipid-lowering drugs, focusing on measures of adherence and clinical outcomes.

Initial Match Rates of an Innovative International Partnership: The Ochsner Clinical School Experience.

Background: Ochsner Clinical School (OCS) is a unique partnership between Ochsner Health System in New Orleans, LA, and The University of Queensland (UQ) School of Medicine in Brisbane, Australia. OCS trains physicians in global medicine and promotes careers in primary care through its unique structure. The purpose of this study was to determine how OCS graduates perform in the National Resident Matching Program (NRMP)-The Match-compared to applicants from other types of medical schools.

The Interaction Between Statins and Exercise: Mechanisms and Strategies to Counter the Musculoskeletal Side Effects of This Combination Therapy.

Background: Broad indications for the use of statin medications are resulting in more patients using these therapies. Simultaneously, healthcare professionals are strongly advocating recommendations to increase exercise training (ET) as a means of decreasing cardiovascular disease (CVD) risk and improving other parameters of fitness.

Methods: We review the literature to explore mechanisms that may increase the risk of statin/ET interactions, examine the benefits and risks of combining ET and statin use, and offer strategies to minimize the hazards of this combination therapy.

Recruiting primary care physicians to teach medical students in the ambulatory setting: a model of protected time, allocated money, and faculty development.

Problem: Medical schools face barriers to recruiting physicians to teach in the ambulatory setting for many reasons, including time required to teach, loss of productivity when learners are present, and physicians' uncertainty about how to teach.

Approach: In 2012, the primary care department of the University of Queensland-Ochsner Clinical School (UQ-OCS) implemented an innovative model for recruiting primary care physicians to teach students in their clinics. The model's three-pronged approach allows protected teaching time, allocates tuition money to reimburse physicians for teaching via educational value unit (EVU) tracking, and includes a faculty development program.

Long-term effects of a diabetes boot cAMP on measures of diabetic care.

Background: Diabetic patients should receive self-management education to improve self-care and quality of life but are frequently unable to attend such programs because of the time commitment. We instituted an intensive 2-hour Diabetes Boot Camp to provide this education in a condensed time frame. The objective was to determine the long-term effect of the boot camp on mean hemoglobin A1c (HgA1c) levels in patients with diabetes compared to diabetic patients receiving the standard of care.

Patient Preferences for Doctor Attire: The White Coat's Place in the Medical Profession.

Background: The white coat's place in the medical profession is a heavily debated topic. Five years after the bare-below-the-elbow policy took effect in England, we reexamined the evidence about coats' potential to transmit infection, reviewed previous studies, and explored our patients' opinions on doctor attire.

Methods: We administered a survey at 3 locations in the Ochsner Health System (hospital clinic, satellite clinic, and inpatient ward) in 2013.

Effects of a diabetes boot cAMP on hemoglobin a1c levels.

Background: Diabetic education can have significant effects in improving glycemic markers in patients with diabetes. This study sought to determine if the Diabetes Boot Camp, a novel 2-hour, intensive educational program by a multidisciplinary team, was effective in lowering mean hemoglobin A1c (HgA1c) levels in diabetic patients when compared to the standard of care.

Methods: The research design was that of a retrospective cohort study.

Impact of coenzyme Q-10 on parameters of cardiorespiratory fitness and muscle performance in older athletes taking statins.

Many older athletes take statins, which are known to have potential for muscle toxicity. The adverse effects of statins on muscles and the influence thereof on athletic performance remain uncertain. Coenzyme Q-10 (CoQ10) may improve performance and reduce muscle toxicity in older athletes taking statins.

Collateral benefits of improving glycemic control on lipids in a diabetic population.

Background: Diabetes is an illness with multiple quality indicators. This retrospective cohort study sought to determine if interventions directed at physicians to target improvements in hemoglobin A1c (HgA1c) quality indicators had collateral benefits on similarly measured low-density lipoprotein (LDL) indicators.

Methods: We initially analyzed the primary care diabetic patient electronic databases from 2008 (N  =  16,503) and 2010 (N  =  23,040).

Differences and similarities in the practice of medicine between australia and the United States of america: challenges and opportunities for the university of queensland and the ochsner clinical school.

Background: In 2008, The University of Queensland (UQ) in Australia and the Ochsner Health System (OHS) in Louisiana entered into a partnership that will allow a cohort of United States (US) citizens to enroll in an Australian medical degree program in which students will study for their first 2 years of medical school in Brisbane, Australia, and then complete the final 2 years of clinical education at OHS in New Orleans. The program's goal is to create graduates eligible to practice in Australia, New Zealand, and/or the US.

Methods: We reviewed the UQ School of Medicine-established Ochsner Clinical School (OCS) and the translation of the UQ clinical curriculum to the US.

Coenzyme q10 and statin-induced mitochondrial dysfunction.

Coenzyme Q10 is an important factor in mitochondrial respiration. Primary and secondary deficiencies of coenzyme Q10 result in a number of neurologic and myopathic syndromes. Hydroxyl-methylglutaryl coenzyme A reductase inhibitors or statins interfere with the production of mevalonic acid, which is a precursor in the synthesis of coenzyme Q10.

Sera from patients with diabetes do not alter the effect of mammalian target of rapamycin inhibition on smooth muscle cell proliferation.

Clinical studies of drug-eluting stents delivering the mammalian target of rapamycin (mTOR) inhibitor, rapamycin (Sirolimus), have demonstrated a reduced efficacy for these devices in patients with diabetes, which suggests that the mTOR pathway may cease to be dominant in mediating the vascular response to injury under diabetic conditions. We hypothesized that changes in serum composition accompanying diabetes may reduce the role of mTOR in mediating the vascular response to injury. We measured the ability of a median dose of rapamycin (10 nM) to inhibit the proliferation of human coronary artery smooth muscle cells (huCASMCs) stimulated with serum obtained from donors with diabetes (n = 14) and without diabetes (n = 16).