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Peptostreptococcus infective endocarditis is rare but associated with high morbidity. We report two cases and evaluate all positive blood cultures for Peptostreptococcus at our institution, followed by a review of the literature. This organism causes a subacute presentation and cardiac valve pathology is a risk factor. Penicillin remains the treatment of choice.
Recent developments in health care delivery in the United States have left many professionals baffled by the continuing changes in practice sparked by the relatively new managed care environment. Psychologists who practice in medical settings are struggling to balance the seemingly competing needs to deliver quality care to clients and patients, while meeting the demands of third-party payers and trying to remain true to their ethical responsibilities. Critical elements of managed care, which many suggest compromise the ethical provision of quality care, include utilization review, financial incentives, and threats to confidentiality. Recommendations are proposed so that mental health professionals may be proactive in protecting their ethical responsibilities in this changing environment....
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