المؤلفون: Savarino, Jeffrey R., Rubin, Emily, Masiakos, Peter T., McLellan, Rachel, Rolle, Myron L., Nanda, Pranav, Stapleton, Christopher J., Sacks, Chana A.

المصدر: Annals of Surgery Open ; volume 5, issue 2, page e418 ; ISSN 2691-3593

الوصف: Objective: We sought to identify people who survived firearm suicide attempts to describe the acute stressors, substance use, and mental health conditions related to the attempt. Background: Most firearm deaths in the United States are the result of suicide. Because firearm suicide attempts have a case fatality rate of approximately 90%, little is known about the precipitating factors that lead to firearm suicide attempts. Methods: We conducted a retrospective case series of patients admitted to a large hospital system between 2000 and 2019 who survived intentional, self-inflicted gunshot wounds to the head. Through the electronic medical record, we collected information about acute stressors, substance use, and mental health diagnoses before or at the time of the suicide attempt. Results: Thirty-four patients were included in the study cohort. Patients were predominantly White (74%) and male (88%), with a mean age of 44 (range, 14–82). Nineteen (56%) patients were acutely intoxicated with alcohol upon hospitalization and 17 (50%) patients had a positive urine drug screen. Acute stressors involving interpersonal relationships (53%), work/school (32%), and legal disputes (18%), among others, were documented in 82% of patients. Most patients (65%) had been diagnosed with depression before their index hospitalization. Most patients were discharged to an acute rehabilitation center (41%) or an inpatient psychiatric facility (41%). Conclusions: Acute stress and alcohol intoxication were common in this cohort of patients who attempted suicide using firearms. These data offer an ability to learn from the experience of survivors of firearm suicide attempts, a rare population.

الإتاحة: https://doi.org/10.1097/as9.0000000000000418Test

المؤلفون: Rolle, Myron L., Garba, Deen L., Kharbat, Abdurrahman F., Bhebhe, Arnold, Mwenge, Felix, Nahed, Brian V., Kerry, Vanessa B.

المصدر: Brain and Spine ; volume 3, page 101755 ; ISSN 2772-5294

الإتاحة: https://doi.org/10.1016/j.bas.2023.101755Test
https://api.elsevier.com/content/article/PII:S2772529423000437?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772529423000437?httpAccept=text/plainTest

المؤلفون: Rolle, Myron L.¹ (AUTHOR), Williams, Ashley^1,2 (AUTHOR) ashleywilliams@oakland.edu, Boeykens, Annegien^3,4 (AUTHOR), Garba, Deen L.⁵ (AUTHOR), McLellan, Rachel¹ (AUTHOR), Francis, Michael⁶ (AUTHOR), dos Santos Rubio, Ellianne^3,7 (AUTHOR)

المصدر: World Neurosurgery. Nov2023, Vol. 179, pe150-e159. 10p.

مصطلحات موضوعية: *NEUROSURGEONS, *MEDICAL practice, *CULTURAL pluralism, *NEUROSURGERY, *MEDICAL referrals, *LABOR supply

مصطلحات جغرافية: CARIBBEAN

الشركة/الكيان: CARIBBEAN Community

مستخلص: The neurosurgical workforce in the Caribbean and surrounding countries is largely unknown due to the diversity in cultural, linguistic, political, financial disparities, and colonial history between the countries. About 45 neurosurgeons serve 16 million people in the Caribbean Community and Common Market, a trade alliance including most Caribbean nations. We aimed to understand the current scope of neurosurgical workforce in this region while highlighting any system challenges and potential solutions for upscaling the workforce. We surveyed neurosurgeons within Caribbean countries and surrounding countries online using qualitative and quantitative methods via Qualtrics. Of the 38 countries within the Caribbean and surrounding countries, 26 (68%) were surveyed and of which 18 (69%) replied. In total, 172 regional neurosurgeons were identified, of which 61 (35%) replied—with a majority of general neurosurgeons (56%). Remarkably, the majority of countries failed to meet the threshold workforce density for safe health care—either expressed by full-time equivalent neurosurgeons or neurosurgical centers (see table). Most neurosurgical practices confirmed receiving or sending medical referrals. If so, most referrals took longer than 8 hours without significant difference regarding the destination. Lastly, challenges confronting neurosurgical advancement were found in the following: technology and equipment (40%), trained personnel (31%), hospital or medical center infrastructure (14%), neurosurgical education, and training (44%). To our knowledge, this is the first qualitative and quantitative study exploring the current status of the neurosurgical workforce within the Caribbean and surrounding countries. Identifying resources and challenges can contribute to improving regionalized neurosurgical care. [ABSTRACT FROM AUTHOR]

المؤلفون: Kanmounye, Ulrick Sidney, Nguembu, Stephane, Zolo, Yvan, Sichimba, Dawin, Rolle, Myron L, Sammar, Adam, Bankole, Nourou Dine Adeniran, Kabulo, Kantenga DN, Cheserem, Beverly, Park, Kee B, Karekezi, Claire, Esene, Ignatius

المصدر: General Surgery, East Africa

مصطلحات موضوعية: Africa, bibliometrics, neurosurgery, scientometrics, research, Neurology, Surgery

الوصف: Background The use of quantitative and qualitative scientometrics provides deductive and inductive insights into the landscape of research in a specic area. In this manuscript, the authors identied the major contributors of African neurosurgery and emerging terms. Methods Articles on African neurosurgery were searched on Web of Science and 8 other repositories without language or date restrictions. The H-index, co-author, author country, time trend, and keyword analyses were done using Bibexcel and VOSviewer. Results 115 articles on African neurosurgery were published in 36 journals by 90 rst authors. The journals with the most articles were World Neurosurgery (46, 40.0%), Journal of Neurosurgery Pediatrics (8, 7.0%), and Neurosurgery (7, 6.1%). There was a rapid increase in the number of articles from 2010 and the median number of citations was 8 (IQR: 4-16). Qureshi MM had the highest H-index score (6) while Warf BC (5, 4.3%), Adeleye AO (4, 3.5%), and El Khamlichi (4, 3.5%) contributed the most to the 115 articles. The articles by Lanzino G (1999), Warf BC (2011), and Warf BC (2005) were the most influential. The U.S.A. had the largest node and South Africa, Kenya and Uganda were the most impactful African countries. Pediatric neurosurgery dominated the keywords and global neurosurgery was an emerging term. Conclusion The most cited articles on African neurosurgery are published in prestigious specialty journals and neurosurgeons from Southern and East Africa are the most impactful local researchers. Future research should analyze the differences between African regions.

العلاقة: https://ecommons.aku.edu/eastafrica_fhs_mc_gen_surg/71Test; chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://web.archive.org/web/20210604193141id_/https://assets.researchsquare.com/files/rs-564592/v1/069c5191-8d46-4fac-aae6-83688efcbe53.pdfTest

الإتاحة: https://ecommons.aku.edu/eastafrica_fhs_mc_gen_surg/71Test

المؤلفون: Rolle, Myron L.¹ (AUTHOR) MROLLE@partners.org, Pascual, Juan Silvestre G.² (AUTHOR), Williams, Ashley L.^3,4 (AUTHOR), West, Timothy¹ (AUTHOR), McLellan, Rachel¹ (AUTHOR), Khu, Kathleen Joy O.² (AUTHOR), Baticulon, Ronnie E.² (AUTHOR), Duhaime, Ann-Christine¹ (AUTHOR)

المصدر: World Neurosurgery. Sep2023, Vol. 177, pe26-e33. 8p.

مصطلحات موضوعية: *BRAIN injuries, *TRAUMA centers, *HIGH-income countries, *CHILDREN'S injuries, *RESOURCE-limited settings, *GLASGOW Coma Scale

مصطلحات جغرافية: PHILIPPINES

الشركة/الكيان: MASSACHUSETTS General Hospital

مستخلص: Pediatric cranial trauma is the leading cause of acquired death and disability in children worldwide. However, trauma resources vary widely among countries. We sought to compare management and timely access to care between a level 1 U.S. pediatric trauma center and a tertiary referral hospital in a lower-middle-income country to assess whether system and resource differences influence care and outcomes. We compared data from 214 pediatric head trauma admissions to Philippine General Hospital (Manila) with 136 children from the TRACK-TBI pediatrics study cohort at Massachusetts General Hospital (MGH). Admitted MGH patients were compared with the Philippine cohort regarding demographics; mechanism of injury; times to neurosurgical consult, imaging, and surgery; in-hospital mortality; and length of hospitalization. Age (9 years), gender distribution (67% male), and presenting Glasgow Coma Scale scores were similar (P = 0.10) between sites. More children had intracranial injury in the Philippine cohort (73% vs. 60%; n = 319) and more underwent neurosurgery (27% vs. 4%). Times to consult, imaging, and surgery were longer in the Philippines (12.3 vs. 6.5, 12.0 vs. 2.8, and 45.4 vs. 5.6 hours, respectively). In-hospital mortality across all admissions was similar between cohorts (3% vs. 0%; P = 0.09), but significantly higher in the most severe Philippines cases (31% vs. 0%, P =0.04). Length of stay was longer (5 vs. 2 days; P < 0.001) in the Philippine cohort. High-income country status correlated with faster care, shorter hospitalizations, and better outcomes among severe cases. Prompt care through sophisticated trauma system implementation may improve pediatric health in resource-limited settings. [ABSTRACT FROM AUTHOR]

المؤلفون: Rolle, Myron L, Bhebhe, Arnold, Munkondya, Aaron, Kharbat, Abdurrahman F, Kaskie, Natasha, McLellan, Rachel, Nahed, Brian V, Warf, Benjamin C, Kunda, Humphrey, Sichizya, Kachinga

المصدر: World Neurosurg ; ISSN:1878-8769 ; Volume:167

مصطلحات موضوعية: Hydrocephalus, Lower middle-income country neurosurgery, Neural tube defect, Neurosurgery determinants of health, Pediatric neurosurgery, Pediatric postoperative care, Socioeconomic determinants of health

الوصف: Pediatric postoperative neurosurgical care is an essential component of a child's treatment pathway. It is important to better understand how neurosurgeons in lower middle-income countries (LMICs) have been able to address socioeconomic and systemic factors to improve their patients' access to quality pediatric postoperative neurosurgical care. We aim to characterize the pediatric neurosurgical postoperative system in place in Zambia and to discuss how these efforts have been implemented to improve outcomes and address socioeconomic barriers to accessing health care.

العلاقة: https://doi.org/10.1016/j.wneu.2022.08.098Test; https://pubmed.ncbi.nlm.nih.gov/36049724Test

الإتاحة: https://doi.org/10.1016/j.wneu.2022.08.098Test
https://pubmed.ncbi.nlm.nih.gov/36049724Test

المؤلفون: Rolle, Myron L., McLellan, Rachel M., Nanda, Pranav, Patel, Aman B., Sacks, Chana A., Masiakos, Peter T., Stapleton, Christopher J.

المصدر: The Neurohospitalist ; volume 12, issue 3, page 444-452 ; ISSN 1941-8744 1941-8752

مصطلحات موضوعية: Neurology (clinical)

الوصف: Objective To assess the clinical, racial, and social characteristics of victims of Gunshot wounds (GSWs) to the head and assess for associations between these factors and outcomes. Summary Background Data Previous literature has not focused on the association of race and socioeconomic factors with these specific injuries. Methods We identified patients with GSWs to the head who presented to 2 urban academic medical centers between 1998 and 2020, and extracted patient-level demographic data, information about the clinical and surgical course, and outcomes at discharge and follow-up. Results The cohort included 250 patients, 90% (n = 226) of whom were male, with a mean age of 28 years. Forty-five percent were white (n = 112), 19% Black (n = 48), 18% Latinx (n = 45), with 6% “other” (n = 16), and 12% “unknown” (n = 29). The majority of patients presented with assault-related trauma (n = 153, 61%) as compared to self-inflicted injuries (n = 97, 39%). Across the entire cohort, sex, age, race, and median income by ZIP code were not significant predictors of outcome. Victims of assault by GSW to the head were more likely to be age 18 or younger (OR 5.26, P = 0.01), between the ages of 19 and 33 years (OR 4.7, P = 0.001), Black (OR 6.66, P < .001), and Latinx (OR 2.65, P = 0.03). Most patients (n = 155, 63%) had a poor functional outcome (modified Rankin Score 3–6) at discharge. Conclusion Age, race, and income status were not independent predictors of mortality or functional outcome at discharge in our population. Assault-related GSWs to the head mostly involved young Black or Latinx men of lower socioeconomic status, while self-inflicted injuries were largely seen in older white men.

الإتاحة: https://doi.org/10.1177/19418744221077552Test

المؤلفون: Detchou, Donald, Ibrahim, Lina I., Tissot, Marianne I. J., Boyke, Andre E., Shlobin, Nathan A., Sharma, Vaishnavi, Rolle, Myron L.

المصدر: Neurosurgery ; volume 90, issue 6, page e197-e198 ; ISSN 0148-396X 1524-4040

الإتاحة: https://doi.org/10.1227/neu.0000000000002003Test

المؤلفون: Rolle, Myron L., McLellan, Rachel M., Nanda, Pranav, Patel, Aman B., Sacks, Chana A., Masiakos, Peter T., Stapleton, Christopher J.

مصطلحات موضوعية: FOS: Clinical medicine, 110306 Endocrinology, 110904 Neurology and Neuromuscular Diseases

الوصف: Supplemental Material, sj-pdf-1-nho-10.1177_19418744221077552 for Racial and Social Determinants of Civilian Gunshot Wounds to the Head by Myron L. Rolle, Rachel M. McLellan, Pranav Nanda, Aman B. Patel, Chana A. Sacks, Peter T. Masiakos and Christopher J. Stapleton in The Neurohospitalist

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::53dd91e64c11274bc9f34a9786659e72Test

المؤلفون: Rolle, Myron L., Garba, Deen L., Sconyers, Olivia, Haynes, Charis

المصدر: World Journal of Surgery ; volume 46, issue 1, page 292-293 ; ISSN 0364-2313 1432-2323

الإتاحة: https://doi.org/10.1007/s00268-021-06240-yTest