Emergency department use during pregnancy by Medicaid type.

Background: Emergency department (ED) use is common among patients with Medicaid insurance during pregnancy. However, it is unknown how ED utilization differs among those with different types of Medicaid such as Emergency Medicaid, with which access to outpatient care is more restricted.

Objective: We sought to compare differences in ED use during between pregnant persons with Emergency Medicaid and Traditional Medicaid and pregnancy outcomes by ED utilization.

Return to play in professional football players following traumatic cervical spine injury: expert opinions from the National Football League spine surgeons.

Objective: There is a paucity of high-quality return-to-play (RTP) data following treatment of cervical spine injuries in contact sports. In this study, the authors gathered insights from National Football League (NFL) team spine surgeon consultants to highlight current practices in treating cervical spine injuries and report decision-making regarding RTP in professional American football players.

Methods: A cross-sectional, online survey was distributed to all NFL consulting physicians specializing in the management of spine injuries.

Antibiotic Management and Imaging Practices of Sinusitis-Related Epidural Empyema among Pediatric Centers.

A survey of pediatric infectious diseases clinicians from 49 children's hospitals demonstrated variability across institutions in the treatment of epidural empyema from sinus extension, including antibiotic route, selection, and impact of neuroimaging on determining duration of therapy.

The role of combination surgery and radiotherapy in patients with metastatic spinal cord compression: What are the remaining grey areas? A systematic review.

Objective: Traditional management of patients with metastatic epidural spinal cord compression (MESCC) consists of radiotherapy (RT) with or without surgical decompression. With extensive literature and the introduction of clinical frameworks, such as the neurologic, oncologic, mechanical, and systemic criteria and the epidural spinal cord compression scale, progress has been made in refining the appropriate treatment regimen. In this review, we analyze the existing literature to identify the consensus frameworks and the remaining gaps in clinical knowledge.

Sociodemographic differences in treatment of acute respiratory infections in pediatric urgent cares.

Objective: To determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race/ethnicity, insurance, and language.

Design: Multi-center cohort study.

Setting: Nine organizations (92 locations) from 22 states and Washington, DC.

Predictors of cost of admission for robot-assisted pedicle screw placement.

Objective: The authors investigated the predictors of cost of admission (CoA) for robot-assisted pedicle screw placement to assess the value of robotic systems in spine operations.

Methods: Demographic, operative, and postoperative variables were retrospectively collected from 506 patients undergoing robot-assisted spine surgery utilizing the ExcelsiusGPS robot at two high-volume tertiary care centers from 2017 to 2023. Perioperative parameters were evaluated against total hospital admission cost utilizing the Kruskal-Wallis and Wilcoxon rank-sum tests followed by multivariable linear regression.

Accuracy of Pedicle Screw Placement Using the ExcelsiusGPS Robotic Navigation Platform: An Analysis of 728 Screws.

Background: Robotic platforms have increased in sophistication for pedicle screw placement. Here, we review our institutional experience using ExcelsiusGPS to assess the accuracy rate of pedicle screw placement throughout the spine and characterize predictors of placement inaccuracy.

Study Design: Retrospective cohort study.

Association of Antibiotic Route and Outcomes in Children with Methicillin-Resistant Staphylococcus aureus Bacteremic Osteomyelitis.

Introduction: There remains uncertainty about whether transitioning to oral antibiotic therapy is appropriate for the management of children with methicillin-resistant Staphylococcus aureus (MRSA) bacteremic osteomyelitis. We compared clinical outcomes for children with MRSA osteomyelitis with associated bacteremia who were transitioned to discharge oral antibiotic therapy to those discharged on outpatient parenteral antibiotic therapy (OPAT).

Methods: We performed a retrospective, multicenter, cohort study of children ≤ 18 years hospitalized with MRSA bacteremic osteomyelitis across four children's hospitals from 2007 to 2018 discharged on oral antibiotic therapy versus OPAT.

Antimicrobial stewardship to reduce overtreatment of asymptomatic bacteriuria in critical access hospitals: measuring a quality improvement intervention.

Background: Asymptomatic bacteriuria (ASB) treatment is a common form of antibiotic overuse and diagnostic error. Antibiotic stewardship using the inappropriate diagnosis of urinary tract infection (ID-UTI) measure has reduced ASB treatment in diverse hospitals. However, critical access hospitals (CAHs) have differing resources that could impede stewardship.

Update on outpatient antibiotic prescribing during the COVID-19 pandemic: United States, 2020-2022.

We updated a descriptive analysis of national outpatient antibiotic prescribing during the COVID-19 pandemic. Prescribing volume was lower during 2020 and January-June in 2021 and 2022 compared to corresponding baseline months in 2019. Prescribing approached or exceeded baseline during July-December of 2021 and 2022 for all antibiotics, especially for azithromycin.

Optimal Pediatric Outpatient Antibiotic Prescribing.

Importance: In the US, 50% of all pediatric outpatient antibiotics prescribed are unnecessary or inappropriate. Less is known about the appropriateness of pediatric outpatient antibiotic prescribing.

Objective: To identify the overall percentage of outpatient antibiotic prescriptions that are optimal according to guideline recommendations for first-line antibiotic choice and duration.

Opportunities to Improve Antibiotic Prescribing for Adults With Acute Sinusitis, United States, 2016-2020.

Background: Better understanding differences associated with antibiotic prescribing for acute sinusitis can help inform antibiotic stewardship strategies. We characterized antibiotic prescribing patterns for acute sinusitis among commercially insured adults and explored differences by patient- and prescriber-level factors.

Methods: Outpatient encounters among adults aged 18 to 64 years diagnosed with sinusitis between 2016 and 2020 were identified by national administrative claims data.

Nondysraphic Intramedullary Spinal Cord Lipomas in the Adult Population.

Objective: Intramedullary spinal cord lipomas without spinal dysraphism are rare. Although they are benign tumors, they can cause significant neurological deficits. Their tight adherence to the spinal cord presents a challenge for resection.

Efficacy and Safety of Pharmacokinetically-Driven Dosing of Mycophenolate Mofetil for the Treatment of Pediatric Proliferative Lupus Nephritis-A Double-Blind Placebo Controlled Clinical Trial (The Pediatric Lupus Nephritis Mycophenolate Mofetil Study).

Background: The safety and efficacy of mycophenolate mofetil (MMF) for lupus nephritis (LN) treatment is established in adults and in some children. MMF is rapidly converted to the biologically active metabolite mycophenolic acid (MPA) whose pharmacokinetics (PK) is characterized by large inter- and intra-individual variability.

Methods/design: This randomized, double-blind, active comparator, controlled clinical trial of pediatric subjects with proliferative LN compares pharmacokinetically-guided precision-dosing of MMF (MMF, i.