Provision of inguinal hernia surgery in first-referral hospitals across low- and middle-income countries: Secondary analysis of an international cohort study.

Introduction: Surgical care in first-referral hospitals (FRHs) in low- and middle-income countries (LMICs) is poorly characterized. Inguinal hernia repair can act as a good tracer condition. This study aimed to evaluate the variation in hernia repair across different hospital types in LMICs.

Environmentally sustainable surgical systems.

Surgeons, anaesthetists, wider surgical teams and hospital managers are a large global group that has the capacity and power to play a leadership role to contribute to change. Hospitals are a good target for improvement since they are centres of communities, linking together surrounding healthcare facilities and influencing wider determinants of the environment. District and rural hospitals are good sites to start since they serve large populations, have the least sustained energy and clean water supplies and will benefit most from quality improvement.

Uncertainties and opportunities in delivering environmentally sustainable surgery: the surgeons' view.

Surgery is a carbon-heavy activity and creates a high volume of waste. Surgical teams around the world want to deliver more environmentally sustainable surgery but are unsure what to do and how to create change. There are many interventions available, but resources and time are limited.

Radiolucent foreign bodies presenting as inflammatory bowel disease: the case of an ingested plastic straw disguising as Crohn's.

More than 80% of ingested foreign bodies are thought to pass spontaneously in the faeces, with fewer than 1% requiring surgical intervention. 'Missed' gastrointestinal foreign bodies are rare and often due to the lack of an obtainable history in patients with communication difficulties or radiolucent foreign bodies. We present the rare case of a 27-year-old woman with severe learning difficulties and a complex surgical history who presented with a 2-year history of increasing abdominal discomfort due to a 'missed' foreign body.

Association of the Careggi Collateral Score with 3-month modified Rankin Scale score after thrombectomy for stroke with occlusion of the middle cerebral artery.

Background: The Careggi Collateral Score (CCS) (qualitative-quantitative evaluation) was developed from a single-centre cohort as an angiographic score to describe both the extension and effectiveness of the pial collateral circulation in stroke patients with occlusion of the anterior circulation. We aimed to examine the association between CCS (quantitative evaluation) and 3-month modified Rankin Scale (mRS) score in a large multi-center cohort of patients receiving thrombectomy for stroke with occlusion of middle cerebral artery (MCA).

Methods: We conducted a study on prospectively collected data from 1284 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke.

Megacities, migration and an evolutionary approach to bipolar disorder: a study of Sardinian immigrants in Latin America.

Objective: To determine whether people with a Sardinian genetic background who live in the megacities of South America have a higher frequency of hypomania than residents of Sardinia.

Methods: A community survey of Sardinian immigrants was carried out in four Brazilian metropoles (n=218) and Buenos Aires (n=306). The results were compared with those of a study involving a similar methodology (Mood Disorder Questionnaire [MDQ] as a screening tool) conducted in seven Italian regions, including a sub-sample from Sardinia.

Hallucinatory experiences, delusional thought proneness, and psychological distress in a nonclinical population.

Despite evidence that the reporting of delusion-like or hallucinatory experiences are predictive of the future development of a mental disorder in the spectrum of psychosis, the exact nature of such a kind of unusual subjective experience in the general population is still disputed. We investigated the multidimensionality of these experiences with the Peters et al. Delusions Inventory (PDI) and a modified Italian version of the Launay-Slade Hallucination Scale (LSHS-R) in 250 subjects of both genders drawn from the normal population, using the General Health Questionnaire (GHQ) as a measure of psychic distress of a clinically relevant nature.