Management of groin hernias detected by ultrasound: a comprehensive study.

INTRODUCTION: It remains unclear whether ultrasound-detected hernias (UDH) are the sole cause of pain in patients with groin pain, and clinical examination plays a complementary role. The aim of our study is to describe the evolution of patients with ultrasound detected hernias in terms of development of groin hernia detected by physical examination, pain resolution, and alternative diagnosis. METHODS: An observational, descriptive, longitudinal study of a prospective case series including patients with UDH with groin pain. Follow-up evaluation included the following: follow-up time, side of pain, its evolution, time to resolution, clinical hernia (CH) development, need for surgical resolution, and the presence of postoperative pain and alternative diagnosis. RESULTS: A total of 98 patients with complete follow-up for groin pain and UDH were included. Seven patients (7.1%) developed CH, with a median time to conversion of 8 months. Four of them (4.1% of the total and 57.1% of the ones who developed CH) ended up having surgery. Fifty-three patients (54.1%) resolved their pain in a median time to resolution of 2 months, and 75.5% of them did so spontaneously. The majority of patients with persistent pain (73.3%) were able to lead a normal life and only reported pain with movement. More than half of the patients (53.3%) reached a specific diagnosis. Among those patients who did not develop CH, 39.6% reached an alternative diagnosis, the majority being musculoskeletal pathologies. CONCLUSION: Watchful waiting and a thorough search for other alternative causes of groin pain in UDH and clinically occult hernia would be a reasonable option.

Laparoscopic-guided distal loco-regional anesthetic infiltration technique in TAPP inguinal hernia repair: a double-blind randomized clinical trial.

BACKGROUND: Ultrasound-guided transversus abdominis plane block (US-TAP) is an important component of multimodal analgesia in laparoscopic inguinal hernia repair, although it has certain limitations. To overcome them, surgeons have developed several techniques to perform local anesthetic infiltration under laparoscopic guidance, but no trials evaluating these in transabdominal preperitoneal (TAPP) hernia repair were conducted till the date. The aim of this study was to compare the efficacy of a novel laparoscopic-guided local anesthetic infiltration technique (LDAI) with US-TAP in postoperative pain control and analgesic consumption for patients undergoing elective TAPP hernia repair. METHODS: This was a double-blind randomized controlled trial conducted at a single tertiary academic center between 2019 and 2020 on adult patients undergoing elective laparoscopic TAPP inguinal hernia repair. Postoperative pain and analgesic consumption were compared for LDAI vs. US-TAP up to 30 postoperative days. RESULTS: 62 patients were included (31 LDAI, 31 US-TAP). Female gender was significantly higher in the LDAI group (8, 25.81%; US-TAP 0; p = 0.005). Mean anesthetic time (US-TAP group: 142.2 min, SD = 17.7; LDAI group: 127.1 min, SD = 15.5; p < 0.001) and mean operative time (US-TAP group: 117.2 min, SD = 15.9; LDAI group: 103.8 min, SD = 15.2; p < 0.001) were significantly shorter in the LDAI group. Pain scores assessed at the first-hour postoperative, at the moment of discharge, and at 8, 24, and 48 postoperative hours showed no significant differences between both groups. No significant difference was found regarding postoperative analgesic rescue administration in the recovery room and analgesic consumption after discharge between groups. CONCLUSION: LDAI is a safe and effective local anesthetic technique in elective TAPP hernia repair. Pain control is similar to US-TAP block, with shorter anesthesthetic and surgical time and better health resources allocation.

The role of alcohol consumption in female victimization: findings from a French representative sample.

Alcohol is frequently related to interpersonal aggression, but information regarding the role of alcohol consumption by victims of severe aggression is however lacking. In order to better understand the dynamic of victimization, we investigated contextual, facilitator, and psychological impact variables related to victimization in a French sample composed of 1,033 females aged 18-74 years. The participants were recruited using quota sampling methodology, and responses were measured using Computer-Assisted Self-Interviewer. A logistic regression was conducted using a backward elimination procedure to identify the significant predictors of blows and wounds suffered in the past 24 months. The results indicated that victims, relative to nonvictims, did binge drink significantly more often, had a higher aggression trait, and had experienced more social hardships in the past. The study's limitations are noted.

Strategies for follow up after hernia surgery during COVID 19 Pandemia.

The end of 2019 was marked by the emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Our problem is centered in the post operative follow up of those patients who underwent an elective procedure immediately before the isolation and those who require an emergency surgery. We outline the measures we have taken to reduce the possibility of spread of the virus.

Multidimensional social control variables as predictors of drunkenness among French adolescents.

BACKGROUND: Previous studies of the determinants of drunkenness among youth investigated the contribution of a limited range of variables measuring social control. For the first time in France, this study including 1295 participants aged 14-19 years aimed at assessing the relative contribution of a broad range of multidimensional variables relating to social control such as parental and school functioning, conventional and religious beliefs, and activity level, in a single model predicting self-reported drunkenness episodes. METHODS: A logistic regression model based on a survey involving nearly 50 measures selected at the first step was conducted using a backward elimination procedure to identify the significant predictors of drunken experience controlling for age, gender and SES among a sample of French adolescents. RESULTS: We found a protective effect of attachment and commitment to institutions in drunkenness experience among youth. Previous findings on parental variables were confirmed with qualifications, whereas the effect of religion was limited. The negative role of sport practice and impulsivity was also emphasized for some participants.

Epidemiological modelling of the 2005 French riots: a spreading wave and the role of contagion.

As a large-scale instance of dramatic collective behaviour, the 2005 French riots started in a poor suburb of Paris, then spread in all of France, lasting about three weeks. Remarkably, although there were no displacements of rioters, the riot activity did travel. Access to daily national police data has allowed us to explore the dynamics of riot propagation. Here we show that an epidemic-like model, with just a few parameters and a single sociological variable characterizing neighbourhood deprivation, accounts quantitatively for the full spatio-temporal dynamics of the riots. This is the first time that such data-driven modelling involving contagion both within and between cities (through geographic proximity or media) at the scale of a country, and on a daily basis, is performed. Moreover, we give a precise mathematical characterization to the expression "wave of riots", and provide a visualization of the propagation around Paris, exhibiting the wave in a way not described before. The remarkable agreement between model and data demonstrates that geographic proximity played a major role in the propagation, even though information was readily available everywhere through media. Finally, we argue that our approach gives a general framework for the modelling of the dynamics of spontaneous collective uprisings.

The theory of planned behavior as mediator of the effect of parental supervision: a study of intentions to violate driving rules in a representative sample of adolescents.

INTRODUCTION: The study reported here was designed to test the ability of the theory of planned behavior to mediate the effect of parental supervision on adolescents' intentions to violate driving rules. METHOD: A representative sample of 1,654 adolescents completed questionnaires during individual and anonymous interviews carried out at their schools. RESULTS: Results showed that age, gender, prior risky driving-behavior, and parental supervision significantly predict intentions to violate driving rules. Attitude and the subjective norm partially mediate the effect of age, prior behavior, and parental supervision. Perceived behavioral control does not predict intention and is not predicted by other variables. IMPACT: The results suggest that social cognitive variables partially mediate the effect of parenting practices such as supervision.

Video Games Exposure and Sexism in a Representative Sample of Adolescents.

Research has indicated that many video games are saturated with stereotypes of women and that these contents may cultivate sexism. The purpose of this study was to assess the relationship between video game exposure and sexism for the first time in a large and representative sample. Our aim was also to measure the strength of this association when two other significant and well-studied sources of sexism, television exposure and religiosity, were also included in a multivariate model. A representative sample of 13520 French youth aged 11-19 years completed a survey measuring weekly video game and television exposure, religiosity, and sexist attitudes toward women. Controlling for gender and socioeconomic level, results showed that video game exposure and religiosity were both related to sexism. Implications of these results for future research on sexism in video games are discussed.

[Social and cultural determinants of juvenile deliquency]. / Les déterminants sociaux et culturels de la délinquance à l'adolescence.

Our knowledge of juvenile delinquency has progressed considerably since the early 1980s, thanks to self-reported delinquency surveys. They teach us that the determinants of delinquent behaviors among teenagers are dependent on the facility with which the offense is committed, the internal motivation (frustration in the family and school, observational learning of the use of violence in the media) and the weakness of social reactions.