Hernia recurrence inventory: inguinal hernia recurrence can be accurately assessed using patient-reported outcomes.

PURPOSE: Relying solely on in-person encounters to assess long-term outcomes of hernia repair leads to substantial loss of information and patients lost-to-follow-up, hindering research and quality improvement initiatives. We aimed to determine if inguinal hernia recurrences could be assessed using the Ventral Hernia Recurrence Inventory (VHRI), a previously existing patient-reported outcome (PRO) tool that can be administered through the telephone and has already been validated for diagnosing ventral hernia recurrence. METHODS: A prospective, multicentric comparative study was conducted. Adult patients from two centers (United States and Brazil) at least 1 year after open or minimally invasive inguinal hernia repair were asked to answer the questions of the VHRI in relation to their prior repair. A physical exam was then performed by a blinded surgeon. Testing characteristics and diagnostic performance of the PRO were calculated. Patients with suspected recurrences were preferentially recruited. RESULTS: 128 patients were enrolled after 175 repairs. All patients answered the VHRI and were further examined, where a recurrence was present in 32% of the repairs. Self-reported bulge and patient perception of a recurrence were highly sensitive (84-94%) and specific (93-94%) for the diagnosis of an inguinal hernia recurrence. Test performance was similar in the American and Brazilian populations despite several baseline differences in demographic and clinical characteristics. CONCLUSION: The VHRI can be used to assess long-term inguinal hernia recurrence and should be reestablished as the Hernia Recurrence Inventory (HRI). Its implementation in registries, quality improvement efforts, and research could contribute to improving long-term follow-up rates in hernia patients.

Integrated Effect of Host Plant Resistance and Fungicidal Seed Treatment on Rice Blast Control in Brazil.

A field experiment was conducted in two successive years at Goiânia, GO, Brazil, to study the effect of seed treatment with pyroquilon fungicide (4.0 g a.i. per kg of seed) on rice blast in cultivars that differed in their level of resistance. Leaf and panicle blast progress was monitored in the newly released, early maturing upland rice cultivar Guarani and the advanced line CNA 4136, and compared with disease progress in the susceptible commercial cultivars IAC 165 and IAC 25 in plots with treated and untreated seed. Seed treatment suppressed leaf blast until 62 and 47 days after seeding in 1987 and 1988, respectively, when averaged across cultivars. The slow blasting nature of Guarani and CNA 4136 increased the level of disease control when environmental conditions favored blast development in 1988. Under high disease pressure the correlation between leaf blast and panicle blast severity in the field plots was negative (r = -0.5, P = 0.01). Leaf blast severity at 47 days after seeding was negatively correlated to grain yield (r = -0.709, P = 0.001). Guarani exhibited an increase in grain yield over the untreated control of 28%, corresponding to 826 kg/ha.