Steroids in the treatment of group A streptococcal necrotizing soft tissue infection.

Background: Group A streptococcal necrotizing soft-tissue infection with toxic shock is a life-threatening disease. Corticosteroid use in the treatment of this process has been reported rarely.

Method: Case reports and review of pertinent literature.

Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission.

Background: Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals.

Methods: A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design.

Experience with ConsultWiz--the simultaneous electronic notification, documentation, and tracking of inpatient consult requests.

ConsultWiz is a component of Vanderbilt's electronic order-entry system that facilitates and documents requests for medical and surgical consult services in the adult and children's hospitals. Piloted in the Dept of Medicine in Spring, 2005, ConsultWiz was expanded to include all remaining adult services in July, 2005 and all pediatric consult services in October, 2005. By February, 2006, over 10,000 consult requests were placed.

Inhibition of staphylococcal wound infection and potentiation of antibiotic prophylaxis by a recombinant fragment of the fibronectin-binding protein of Staphylococcus aureus.

Adherence of Staphylococcus aureus to host tissues is a critical step for colonization and initiation of infection. The fibronectin-binding proteins (FnBPs) of S. aureus have been implicated in adherence and internalization in nonprofessional phagocytes.