ABSTRACT
Data become information when they can be summarized and organized into logical patterns; information becomes knowledge when it can be manipulated for actionable decision making; knowledge becomes insight when contextually relevant and temporarily appropriate. This article describes how information technology can now be used to provide clinicians with access to both insight and information that is context- and event-sensitive. Collaboration between the American College of Physicians, medical knowledge experts, Oregon Health Sciences University (OHSU), and shared medical systems for framework and infrastructure combine to create the ideal environment of complementary and synergistic competencies. This article describes the research that is under way at OHSU to determine how to deploy medical knowledge derived from these sources and integrate it into the clinical workflow; it also examines a vision of how medical knowledge can be integrated in the future.
Subject(s)
Integrated Advanced Information Management Systems , Internet , Knowledge , Education, Medical, Continuing , Humans , Information Management , Oregon , Systems IntegrationABSTRACT
We describe what we believe to be the second case in which a pregnancy was complicated by the formation of brain abscesses due to Nocardia asteroides; this case may be the first one in which no risk factor for the infection (other than the pregnancy itself) could be found. Craniotomy with surgical drainage of the abscesses, combined with prolonged antimicrobial therapy, led to clinical cure in the mother, and she gave birth to an unaffected infant. This case illustrates the difficulty in treating a nocardial infection of the brain during pregnancy as well as the importance of achieving adequate surgical drainage of the abscesses.
Subject(s)
Brain Abscess/surgery , Craniotomy , Nocardia Infections/surgery , Nocardia asteroides/isolation & purification , Pregnancy Complications, Infectious/surgery , Adult , Ampicillin/therapeutic use , Brain Abscess/drug therapy , Brain Abscess/microbiology , Ceftriaxone/therapeutic use , Combined Modality Therapy , Drug Therapy, Combination , Female , Humans , Nocardia Infections/drug therapy , Nocardia Infections/microbiology , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/microbiology , Sulfisoxazole/therapeutic useABSTRACT
The first report of prosthetic valve endocarditis due to a nutritionally variant streptococcus is presented. A 21-year-old woman developed persistent fever within one week of mitral valve replacement. Prosthetic valve dysfunction developed necessitating valve replacement. Cultures of blood and the excised prosthetic valve using routine media were negative; Streptococcus mitior grew as satellite colonies around Staphylococcus aureus and in beef heart infusion broth supplemented with 0.001% pyridoxine HCl. Treatment with penicillin G and streptomycin for six weeks was curative. Nutritionally variant streptococci should be considered in patients with prosthetic valve endocarditis and negative routine cultures.
