Background:Methicillin-resistant Staphylococcus aureus has been the most commonly identified pathogen in hand infections at urban centers, but the evolving antibiotic sensitivity profiles of methicillin-resistant Staphylococcus aureus are not known. The purposes of this study are to determine if mul

Summary: Objective: To examine national trends of pediatric epilepsy surgery usage in the United States between 1997 and 2009.Methods: We performed a serial cross‐sectional study of pediatric epilepsy surgery using triennial data from the Kids’ Inpatient Database from 1997 to 2009. The rates of epilepsy surgery for lobectomies, partial lobectomies, and hemispherectomies in each study year were calculated based on the number of prevalent epilepsy cases in the corresponding year. The age‐race‐sex adjusted rates of surgeries were also estimated. Mann‐Kendall trend test was used to test for changes in the rates of surgeries over time. Multivariable regression analysis was also performed to estimate the effect of time, age, race, and sex on the annual incidence of epilepsy surgery.Results: The rates of pediatric epilepsy surgery increased significantly from 0.85 epilepsy surgeries per 1,000 children with epilepsy in 1997 to 1.44 epilepsy surgeries per 1,000 children with epilepsy in 2009. An increment in the rates of epilepsy surgeries was noted across all age groups, in boys and girls, all races, and all payer types. The rate of increase was lowest in blacks and in children with public insurance. The overall number of surgical cases for each study year was lower than 35% of children who were expected to have surgery, based on the estimates from the Connecticut Study of Epilepsy.Significance: In contrast to adults, pediatric epilepsy surgery numbers have increased significantly in the past decade. However, epilepsy surgery remains an underutilized treatment for children with epilepsy. In addition, black children and those with public insurance continue to face disparities in the receipt of epilepsy surgery.

Analysis of the prospectively collected American College of Surgeons National Surgical Quality Improvement Program database. To assess whether preoperative anemia predicted adverse, early, perioperative outcomes in patients undergoing elective spine surgery. Prior studies have assessed the association of anemia with outcomes in various noncardiac surgical procedures. The association between preoperative anemia and 30-day outcomes for spine surgery is unknown. A total of 24,473 adults, classified as having severe (N = 88), moderate (N = 314), mild (N = 5477), and no anemia. Using propensity scores, patients with severe, mild, and moderate anemia were matched with patients with no anemia. Logistic regression was used to predict adverse postoperative outcomes. Sensitivity analyses were conducted limiting the study sample to patients who did not receive intra- or postoperative transfusion and to patients with and without preoperative cardiovascular comorbidities. Patients with all levels of anemia had significantly higher risk of nearly all adverse outcomes than nonanemic patients in unadjusted and propensity-matched models. Patients with moderate and mild anemia were more likely to have prolonged length of hospitalization, experience 1 or more complications, and expire within 30 days of surgery compared with nonanemic patients. The association between anemia and adverse outcomes was found independently of intra- and postoperative transfusions, and was not more pronounced in patients with preoperative cardiovascular comorbidities. All levels of anemia were significantly associated with prolonged length of hospitalization and poorer operative or 30-day outcomes in patients undergoing elective spine surgery. Our findings, using a large multi-institutional sample of prospectively collected data, suggests that anemia should be regarded as an independent risk factor for perioperative and postoperative complications that deserves attention prior to elective spine surgery. Level of Evidence: 3