The etiology of blood culture-negative endocarditis was identified in 62.7% of 759 patients using combinations of serological, molecular, and histopathological assays. The majority of the agents not detected by conventional cultures were Coxiella burnetii (30%) and Bartonella spp. (11%), both diagnosed using serological tests, and Trophyrema whipplei, other unusual bacteria, and fungi making up the remainder. For 14% of patients, diagnosis required PCR testing on valve tissue removed during surgery (not in paraffin). The cause of disease could not be determined for 264 patients; 2% of patients had non-infectious endocarditis.
This meta-analysis casts serious doubt on the ability of rapid response teams to significantly reduce hospital mortality.
According to the Organ Procurement and Transplantation Network, there are currently more than 100,000 people in the United States in need of life-saving organ transplants. Unfortunately, this demand far exceeds the number of available organs, and each day an average of 18 people die because of the shortage of organs and organ donors.
Pediatric head trauma is a common presenting complaint to the emergency department (ED) and is a major cause of pediatric death and disability. This article will address the epidemiology, pathophysiology, diagnosis, and management of moderate to severe pediatric traumatic brain injury (TBI), with a focus on strategies to improve outcome.
Unfortunate outcomes are a fact of medicine, as too are lawsuits for alleged malpractice.
