Aortic dissection and aortic aneurysm are major life-threatening diseases worldwide.^1,2 Epidemiology studies show that mortality from aortic aneurysm and dissection has risen over the past decades in many developed countries including the United States, Britain, and Japan, with the rate of increase ranging from 1.2 to 24.8 fold.^3-6 In fact, aortic aneurysm has become the 13th leading cause of death, claiming an estimated 15 000 deaths annually in the United States.⁷ Aortic dissection is defined as separation of the layers within the aortic wall, while aortic aneurysm is defined as a localized or diffuse dilation of the aorta.^8,9 Both aortic aneurysm and dissection are caused by weakness of the aortic wall due to congenital defect, hypertension, or chronic inflammation.^8-11 Ruptured aortic aneurysm and dissection are associated with high morbidity and mortality rates.^10,12,13 Many patients even experience out-of-hospital cardiac arrest before the diagnosis of aortic aneurysm or dissection is made.

Blood culture is viewed as the golden standard for the diagnosis of sepsis but suffers from low sensitivity and long turnaround time. LightCycler SeptiFast (LC-SF) is a real-time multiplex polymerase chain reaction test able to detect 25 common pathogens responsible for bloodstream infections within hours. We aim to assess the accuracy of LC-SF by systematically reviewing the published studies. Related literature on Medline, Embase, and Cochrane databases was searched up to October 2012 for studies utilizing LC-SF to diagnose suspected sepsis and that provided sufficient data to construct two-by-two tables. A total of 34 studies enrolling 6012 patients of suspected sepsis were included. The overall sensitivity and specificity for LC-SF to detect bacteremia or fungemia was 0·75 (95% CI: 0·65–0·83) and 0·92 (95%CI:0·90–0·95), respectively. LC-SF had a high positive likelihood ratio (10·10) and a moderate negative likelihood ratio (0·27). Specifically, LC-SF had a sensitivity of 0·80 (95%CI: 0·70–0·88) and a specificity of 0·95(95%CI: 0·93–0·97) for the bacteremia outcome, and a sensitivity of 0·61 (95%CI: 0·48–0·72) and a specificity of 0·99 (95%CI: 0·99–0·99) for the fungemia outcome. High heterogeneity was found in the bacteremia outcome subgroup but not in the fungemia outcome subgroup. LC-SF is of high rule-in value for early detection of septic patients. In a population with low pretest probability, LC-SF test can still provide valuable information for ruling out bacteremia or fungemia.

Review from JAMA Internal Medicine — Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible Populations — A Systematic Review and Meta-analysis of Randomized Controlled Trials