Variations in strength-speed-power performance across the season: do true changes occur in elite rugby players?

This study aimed to determine, through the use of a highly sensitive statistical tool, whether real changes in performance were present; and compare the rates of meaningful variations in strength, speed, and power parameters at different time-points during the competitive season in national team rugby players. Thirty-two players were assessed 5 times across the season using the following tests: squat jump and countermovement jump tests; 30-m sprint velocity; and one-repetition maximum (1RM) in the half-squat and bench-press exercises. A repeated-measures analysis of variance was conducted to test for differences between successive time-points. Individual coefficients of variation values were used to set target scores for post-measurements and examine whether changes in performance parameters were greater than the natural test variance, thus providing an indication of whether "true changes" occurred. No significant changes were detected in the vertical jump height, 1RM measures, and sprint velocity and momentum throughout the 11-month period (P > 0.05). True changes occurred much more frequently for strength-power measures than for sprint velocity and momentum. Elite rugby union players did not exhibit significant variations in neuromuscular performance across the competitive period, when a group-based analysis was conducted. However, at the individual level, "true changes" in strength-power-(but not in speed-) related qualities were consistently observed over the competitive season.

Jump Squats Performed with Both Light and Heavy Loads Have Similar Effects on the Physical Performance of Elite Rugby Players during the Initial Phase of the Competitive Period.

We examined the effectiveness of two different jump-squat (JS) loading ranges on the physical performance of rugby players. Twenty-eight elite male rugby players were divided into two JS training groups: a light-load JS group ("LJS"; JS at 40% of the one-repetition maximum [1RM] in the half-squat (HS) exercise) and a heavy-load JS group ("HJS"; JS at 80% HS-1RM). Players completed the distinct training programs over four weeks, three times per week, during the initial phase of the competitive period. Pre- and post-training tests were conducted in the following sequence: vertical jumps, a 30-m speed test, peak power in the JS and the HS, and maximum isometric force in the HS. Additionally, the rating of perceived exertion (RPE) was assessed at the end of all training sessions throughout the intervention. A two-way ANOVA with repeated measures, followed by the Tukey's post-hoc test, was employed to analyze differences between groups. The level of significance was set at p < 0.05. Effect sizes were used to assess the magnitude of differences between pre- and post-training data. Except for the RPE values (which were lower in the LJS group), no significant changes were detected for any other variable. In summary, using either a light- (40% HS-1RM) or a heavy-load (80% HS-1RM) JS during the initial phase of the competitive period is equally effective in maintaining physical performance levels attained during the preceding training period (pre-season), with the significant advantage of the light-load protocol resulting in lower levels of the RPE. This finding may have important implications for resistance training programming, especially in disciplines where acute and chronic fatigue is always a problematic issue.

Single-row or Double-row Rotator Cuff Repair.

Rotator cuff tears are potentially a career-ending injury for athletes. The surgeon must identify which patients will benefit from surgical repair. The factors to consider are age, type of sport, time since injury, athlete's level, and the patient's expectations. An essential and independent fact determining the surgical treatment is whether the damage is due to overuse or from a traumatic/collision injury. Some sports are more demanding than others resulting in different return-to-participation (RTP) rates. This RTP return rate can present a real challenge and more so by a desire to reach the pre-injury level of play. The incidence of rotator cuff tearing varies from one sport to another. In football players this can be 12% whereas for tennis players this incidence is 4% to 17%. The RTP rate must be considered when making treatment decisions and is influenced by the level of the athlete: for professional athletes, the rate is 61%, and for recreational 73%. When the surgeon and the patient decide on the surgical treatment, the surgeon must consider whether to perform a double-row or a single-row rotator cuff tendon repair. The decision-making and the surgical technique will be addressed.

Half-Squat and Jump Squat Exercises Performed Across a Range of Loads: Differences in Mechanical Outputs and Strength Deficits.

ABSTRACT: Loturco, I, McGuigan, MR, Freitas, TT, Bishop, C, Zabaloy, S, Mercer, VP, Moura, TBMA, Arruda, AFS, Ramos, MS, Pereira, LA, and Pareja-Blanco, F. Half-squat and jump squat exercises performed across a range of loads: differences in mechanical outputs and strength deficits. J Strength Cond Res 37(5): 1052-1056, 2023-The aim of this study was to compare the peak force (PF), peak power (PP), and peak velocity (PV) outputs produced during half-squat (HS) and jump squat (JS) exercises executed at 20, 40, 60, and 80% of 1 repetition maximum (1RM) in the HS (HS 1RM) and to compute and compare the strength deficit (SDef) achieved in these exercises across these loads. Twenty-four national rugby union players (age: 25.7 ± 3.6 years) performed HS 1RM and a progressive loading test in the HS and JS exercises. The PF, PP, and PV values were obtained in all loads for both exercises, and the SDef was calculated as the percentage difference between the PF at distinct relative intensities and the PF at HS 1RM. The differences in HS and JS variables were determined using an analysis of variance with repeated measures. Higher PF, PP, and PV outputs were generated in the JS in comparison with the HS exercise ( p < 0.05); moreover, the SDef magnitudes were significantly lower in the JS ( p < 0.01), for all loading conditions. Importantly, the differences in SDef, and as a consequence, PF, PP, and PV decreased progressively with increasing load. Overall, the loaded JS exhibited increased levels of PF, PP, and PV and reduced levels of SDef when compared to the traditional HS performed across a range of loads. The JS is indicated to reduce the SDef and improve the athletes' ability to apply force at higher velocities. Nevertheless, with heavier loads (i.e., ≥80% HS 1RM), its potential advantages and effectiveness may be seriously compromised.

Ion Microprobe Study of the Polarization Quenching Techniques in Single Crystal Diamond Radiation Detectors.

Synthetic single crystal diamond grown using the chemical vapor deposition technique constitutes an extraordinary candidate material for monitoring radiation in extreme environments. However, under certain conditions, a progressive creation of space charge regions within the crystal can lead to the deterioration of charge collection efficiency. This phenomenon is called polarization and represents one of the major drawbacks associated with using this type of device. In this study, we explore different techniques to mitigate the degradation of signal due to polarization. For this purpose, two different diamond detectors are characterized by the ion beam-induced charge technique using a nuclear microprobe, which utilizes MeV energy ions of different penetration depths to probe charge transport in the detectors. The effect of polarization is analyzed by turning off the bias applied to the detector during continuous or discontinuous irradiation, and also by alternating bias polarity. In addition, the beneficial influence of temperature for reducing the effect of polarization is also observed. Finally, the effect of illuminating the detector with light is also measured. Our experimental results indicate that heating a detector or turning off the bias, and then applying it during continuous irradiation can be used as satisfactory methods for recovering the CCE value close to that of a prepolarized state. In damaged regions, illumination with white light can be used as a standard method to suppress the strength of polarization induced by holes.

Change-of-Direction Deficit vs. Deceleration Deficit: A Comparison of Limb Dominance and Inter-limb Asymmetry between Forwards and Backs in Elite Male Rugby Union Players.

The aims of the present study were to: 1) determine whether limb dominance and inter-limb asymmetry were the same across both change of direction (COD) and deceleration (DEC) deficits and, 2) determine the association between the COD and DEC-deficits and other physical performance tests in elite male rugby union players. Twenty five players performed a series of bilateral jumps, linear and COD speed tests at the end of the pre-season period. COD and DEC-deficits were calculated for both left and right sides, and inter-limb asymmetry thereafter. Kappa coefficients revealed moderate levels of agreement in limb dominance between COD and DEC-deficits (Kappa = 0.41 on left; 0.48 on right). For the direction of asymmetry, perfect levels of agreement (Kappa = 1) were evident between 505 time and COD-deficit, but only moderate levels of agreement (Kappa = 0.41) between other asymmetry measures. Pearson's r correlations showed moderate to large relationships between jumps and linear (r = -0.42 to -0.68) and COD speed (r = -0.41 to -0.58), but not with the COD-deficit (r = 0.15 to -0.31), DEC-deficit (r = 0.01 to -0.32) or asymmetry (r = 0.16 to -0.29). When analysing by playing position, backs were significantly faster than forwards over 15-m (ES = -0.86) and across all jump tests (ES = 0.86-0.94), with the exception of the squat jump. This study is the first to provide a direct comparison of the COD and DEC-deficits and highlights that limb dominance and asymmetry cannot be guaranteed between tasks.

The prefrontal cortex as a target for atypical antipsychotics in schizophrenia, lessons of neurodevelopmental animal models.

Prefrontal cortex (PFC) inflammatory imbalance, oxidative/nitrosative stress (O/NS) and impaired neuroplasticity in schizophrenia are thought to have neurodevelopmental origins. Animal models are not only useful to test this hypothesis, they are also effective to establish a relationship among brain disturbances and behavior with the atypical antipsychotics (AAPs) effects. Here we review data of PFC post-mortem and in vivo neuroimaging, human induced pluripotent stem cells (hiPSC), and peripheral blood studies of inflammatory, O/NS, and neuroplasticity alterations in the disease as well as about their modulation by AAPs. Moreover, we reviewed the PFC alterations and the AAP mechanisms beyond their canonical antipsychotic action in four neurodevelopmental animal models relevant to the study of schizophrenia with a distinct approach in the generation of schizophrenia-like phenotypes, but all converge in O/NS and altered neuroplasticity in the PFC. These animal models not only reinforce the neurodevelopmental risk factor model of schizophrenia but also arouse some novel potential therapeutic targets for the disease including the reestablishment of the antioxidant response by the perineuronal nets (PNNs) and the nuclear factor erythroid 2-related factor (Nrf2) pathway, as well as the dendritic spine dynamics in the PFC pyramidal cells.

Electronic Properties of a Synthetic Single-Crystal Diamond Exposed to High Temperature and High Radiation.

Diamond, as a wide band-gap semiconductor material, has the potential to be exploited under a wide range of extreme operating conditions, including those used for radiation detectors. The radiation tolerance of a single-crystal chemical vapor deposition (scCVD) diamond detector was therefore investigated while heating the device to elevated temperatures. In this way, operation under both high-temperature and high-radiation conditions could be tested simultaneously. To selectively introduce damage in small areas of the detector material, a 5 MeV scanning proton microbeam was used as damaging radiation. The charge collection efficiency (CCE) in the damaged areas was monitored using 2 MeV protons and the ion beam induced charge (IBIC) technique, indicating that the CCE decreases with increasing temperature. This decreasing trend saturates in the temperature range of approximately 660 K, after which CCE recovery is observed. These results suggest that the radiation hardness of diamond detectors deteriorates at elevated temperatures, despite the annealing effects that are also observed. It should be noted that the diamond detector investigated herein retained its very good spectroscopic properties even at an operation temperature of 725 K (≈2% for 2 MeV protons).

Differential expression of miRNAs related to angiogenesis and adipogenesis in subcutaneous fat of obese and nonobese women.

To disclose the mechanisms surrounding obesity, we selected microRNAs (miRNAs) that target genes involved in adipogenesis, angiogenesis, and inflammation and compared their expression levels in the subcutaneous adipose tissue of 40 obese and nonobese women. Mature miRNAs were extracted from subcutaneous adipose tissue samples that were collected during surgery and quantified by real-time polymerase chain reaction. miR-16 was overexpressed in the nonobese group (n-expression ratio = - 151.1; P < 0.001). Furthermore, the expression levels of two other miRNAs were significantly correlated with waist circumference in nonobese women (miR-27b, r = 0.453; P = 0.027 and miR-424-5p, r = 0.502, P = 0.014). Central and total subcutaneous adipose tissue thicknesses were correlated with miR-424-5p levels (r = 0.506, P = 0.034 and r = 0.475, P = 0.046, respectively) in the nonobese group. In the obese group, miR-424-5p expression was correlated with body mass index (r = 0.582, P = 0.018). miR-16 and miR-424 have shown correlations with body-fat-mass-related parameters. Because these miRNAs have vascular endothelial growth factor (VEGF) and its receptors as target genes, they may be involved in the alterations of angiogenesis observed in obesity. In addition, higher levels of miR-27 and miR-424 were correlated with higher fat depot measurements in nonobese women. These results highlight the importance of miRNA expression in subcutaneous adipose tissue and encourage further investigation of miRNAs as prognostic markers.

Kinesin 1 regulates cilia length through an interaction with the Bardet-Biedl syndrome related protein CCDC28B.

Bardet-Biedl syndrome (BBS) is a ciliopathy characterized by retinal degeneration, obesity, polydactyly, renal disease and mental retardation. CCDC28B is a BBS-associated protein that we have previously shown plays a role in cilia length regulation whereby its depletion results in shortened cilia both in cells and Danio rerio (zebrafish). At least part of that role is achieved by its interaction with the mTORC2 component SIN1, but the mechanistic details of this interaction and/or additional functions that CCDC28B might play in the context of cilia remain poorly understood. Here we uncover a novel interaction between CCDC28B and the kinesin 1 molecular motor that is relevant to cilia. CCDC28B interacts with kinesin light chain 1 (KLC1) and the heavy chain KIF5B. Notably, depletion of these kinesin 1 components results in abnormally elongated cilia. Furthermore, through genetic interaction studies we demonstrate that kinesin 1 regulates ciliogenesis through CCDC28B. We show that kinesin 1 regulates the subcellular distribution of CCDC28B, unexpectedly, inhibiting its nuclear accumulation, and a ccdc28b mutant missing a nuclear localization motif fails to rescue the phenotype in zebrafish morphant embryos. Therefore, we uncover a previously unknown role of kinesin 1 in cilia length regulation that relies on the BBS related protein CCDC28B.

Revisional Malabsorptive Bariatric Surgery: 29-Year Follow-up in a Brazilian Public Hospital.

BACKGROUND: This study aimed to evaluate the outcomes of 67 patients who underwent revisional bariatric surgeries over a 29-year period in a Brazilian public hospital. METHODS: The records of all patients who underwent revisional bariatric surgery from January 1987 to December of 2016 at our hospital were analyzed for weight loss and complications. Descriptive statistics and paired t tests were computed. RESULTS: Sixty-seven patients were included in the study. The primary surgeries previously performed on these patients were biliopancreatic diversion with duodenal switch (BPD-DS) (37 cases, 55.2%), jejunoileal bypass (JIB) (24 cases, 35.8%), sleeve gastrectomy (4 cases, 5.9%), Roux-en-Y gastric bypass (RYGB) (1 case, 1.5%), and laparoscopic adjustable gastric band (1 case, 1.5%). The indications for revisional surgery were as follows: malnutrition in 29 cases (43.3%), failure to lose weight in 27 cases (40.3%), weight regain in 5 cases (7.5%), and untreatable diarrhea in 6 cases (9.2%). Most revisional surgeries were performed using JIB or BPD-DS. Operative mortality was higher after the revisional procedures compared with that following the primary bariatric surgeries. CONCLUSIONS: Most patients requiring a revisional surgery had undergone a primary BPD-DS or JIB. Severe and untreatable malnutrition and diarrhea were the main indications for the revisional procedures. RYGB produced significant and sustainable weight loss and exhibited a low risk of malnutrition or requiring revisional surgery.

Nonalcoholic fatty liver disease in patients with different baseline glucose status undergoing bariatric surgery: analysis of intraoperative liver biopsies and literature review.

BACKGROUND: Bariatric surgery has been investigated as a treatment option for obese patients with nonalcoholic fatty liver disease (NAFLD). Because patients with NAFLD and type 2 diabetes show accelerated progression from liver disease to cirrhosis, it has been suggested that surgery could be indicated for patients with lower degrees of obesity and type 2 diabetes. OBJECTIVE: To analyze the degree of tissue damage in liver biopsies obtained from patients undergoing bariatric surgery, correlating histopathologic findings with their baseline glucose status. SETTING: General hospital in the public health system. METHODS: Intraoperative liver biopsies were obtained from 521 obese patients undergoing bariatric surgery. Patients were divided into 3 study groups according to their preoperative glucose levels: 167 (32.05%) type 2 diabetic, 132 (25.33%) prediabetic, and 222 (42.61%) normoglycemic patients. Tissue samples were classified in accordance with Brunt and Clinical Research Network Nonalcoholic Steatohepatis criteria. RESULTS: Prevalence of NAFLD was 95%. Higher rates of hepatic fibrosis were observed in diabetic patients (56.4%) compared with prediabetic (29.2%), and normoglycemic patients (28.6%) (P<.001). Nonalcoholic steatohepatitis was diagnosed in 59.4% of the diabetics, in 49.2% of the prediabetics, and in 36% of the normoglycemic obese (P<.001). Only 1.5% of the diabetics had no histologic hepatic alterations. CONCLUSION: NAFLD is markedly more severe in diabetic patients. Our data suggest that intraoperative liver biopsy should be considered for diabetic patients undergoing bariatric surgery. Early bariatric surgery should be investigated as a means to prevent progression of NAFLD.

Adiponectin promoter polymorphisms are predictors of lipid profile improvement after bariatric surgery

Abstract Our aim was to investigate if single nucleotide polymorphisms (SNPs) located in the 5′ regions of leptin (LEP, -2548 G > A, rs7799039), resistin (RETN, -420 C > G, rs1862513) and adiponectin (ADIPOQ, -11391 G > A, rs17300539 and -11377 C > G, rs266729) genes were related to changes in body mass index (BMI) and metabolic variables after bariatric surgery in 60 extremely obese individuals. At baseline, ADIPOQ -11391 A-allele carriers showed higher plasma adiponectin and lower total cholesterol levels when compared to G/G homozygotes. Approximately 32 months post-surgery, a mean reduction of 35% in BMI and an important improvement in metabolic profiles were observed. In addition, for the ADIPOQ -11377 polymorphism, a higher decrease in lipid profile was associated to the C/C genotype. Moreover, individuals bearing the A-C haplotype for the two ADIPOQ SNPs were more prone to show a reduction in low-density lipoprotein levels after bariatric surgery (-43.0% A-C carriers vs. -18.1% G-G carriers, p = 0.019). We did not find any association of leptin and resistin SNPs with the clinical parameters analyzed. In summary, our results indicate that the A-C haplotype is a predictor of better lipid profile post-surgery and the studied SNPs in ADIPOQ gene are associated to changes in metabolic variables in obese individuals.

Adiponectin promoter polymorphisms are predictors of lipid profile improvement after bariatric surgery.

Our aim was to investigate if single nucleotide polymorphisms (SNPs) located in the 5' regions of leptin (LEP, -2548 G > A, rs7799039), resistin (RETN, -420 C > G, rs1862513) and adiponectin (ADIPOQ, -11391 G > A, rs17300539 and -11377 C > G, rs266729) genes were related to changes in body mass index (BMI) and metabolic variables after bariatric surgery in 60 extremely obese individuals. At baseline, ADIPOQ -11391 A-allele carriers showed higher plasma adiponectin and lower total cholesterol levels when compared to G/G homozygotes. Approximately 32 months post-surgery, a mean reduction of 35% in BMI and an important improvement in metabolic profiles were observed. In addition, for the ADIPOQ -11377 polymorphism, a higher decrease in lipid profile was associated to the C/C genotype. Moreover, individuals bearing the A-C haplotype for the two ADIPOQ SNPs were more prone to show a reduction in low-density lipoprotein levels after bariatric surgery (-43.0% A-C carriers vs. -18.1% G-G carriers, p = 0.019). We did not find any association of leptin and resistin SNPs with the clinical parameters analyzed. In summary, our results indicate that the A-C haplotype is a predictor of better lipid profile post-surgery and the studied SNPs in ADIPOQ gene are associated to changes in metabolic variables in obese individuals.

Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients.

BACKGROUND: Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients. METHODS: This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin-ADIPOQ, leptin-LEP, and resistin-RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria. RESULTS: The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages. CONCLUSION: Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.

Efeitos do treinamento pliométrico sobre a potência de membros inferiores e a velocidade em tenistas da categoria juvenil / Effects of plyometric training in power of lower limbs and peed of junior tennis players

O objetivo do presente estudo é analisar a influência do treinamento pliométrico nas variáveis de potência de membros inferiores e de velocidade em tenistas. Participaram do estudo 11 atletas, sendo 5 do "grupo controle" e 6 do "grupo intervenção". Ambos os grupos realizaram treinamento em quadra e treinamento de força geral em academia. Os testes realizados foram: squat jump, salto contra movimento, salto contra movimento com auxílio dos braços, drop jump, impulsão horizontal e velocidade, sendo estes aplicados pré e pós treinamento pliométrico. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk e ANOVA para medidas repetidas para diferença entre o pré e pós-teste, p<0,05. O grupo de intervenção apresentou diferenças entre o pré e pós-teste para todas as variáveis, diferentemente do grupo controle. E entre o grupo controle e o de intervenção, verificou-se que, no pré-teste, não houve diferença entre as variáveis. A utilização do treinamento pliométrico de 10 semanas induziu a adaptações importantes no desempenho dos sujeitos acompanhados.

The aim of this study was to investigate the effect of plyometric training on the power of lower limbs and speed of tennis players. Participated 11 athletes, 5 were "control group" and 6 "experimental group". The both groups were conducted to training on court and strength training. The abilities investigated were: squat jump, counter movement jump, counter movement jump using the arms, drop jump, broad jump and speed. Shapiro-Wilk test for evaluating the normality and ANOVA two way repeted-measures for evaluating the differences between pretest and posttest, p<0.05. Results comparing pretest and posttest showed a significant improvement in all variables for experimental group, different of the control group. And between control group and experimental, verified no differences to pretest. The plyometric training by 10 weeks induced an performance improvement of the subjects.

Do health benefits outweigh the costs of mass recreational programs? An economic analysis of four Ciclovía programs.

One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost-benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara in México, and San Francisco in the U.S.A. The data of the four programs were obtained from program directors and local surveys. The annual cost per capita of the programs was: U.S. $6.0 for Bogotá, U.S. $23.4 for Medellín, U.S. $6.5 for Guadalajara, and U.S. $70.5 for San Francisco. The cost-benefit ratio for health benefit from physical activity was 3.23-4.26 for Bogotá, 1.83 for Medellín, 1.02-1.23 for Guadalajara, and 2.32 for San Francisco. For the program of Bogotá, the cost-benefit ratio was more sensitive to the prevalence of physically active bicyclists; for Guadalajara, the cost-benefit ratio was more sensitive to user costs; and for the programs of Medellín and San Francisco, the cost-benefit ratios were more sensitive to operational costs. From a public health perspective for promoting physical activity, these Ciclovía programs are cost beneficial.

Using the Prolene Hernia System (PHS) for inguinal hernia repair.

OBJECTIVE: To assess immediate postoperative and late complications in patients with inguinal hernia undergoing surgical correction by Gilbert technique, using the Prolene Hernia System (HPS). METHODS: We surveyed all patients undergoing inguinal hernia repair with PHS mesh at The Sao Lucas Hospital--PUCRS, from January 2001 to october 2006. Information was retrospectively collected through telephone calls and chart review. The protocol for data collection included epidemiological aspects, as well as immediate and late complications. RESULTS: ninety-six patients were enrolled. We identified six (6.25%) complications in different patients, none of which resulting in death. Two patients (2.08%) had seroma; hematoma was identified in one patient (1.04%); one patient (1.04%) had wound infection. Two patients (2.08%) had scrotal edema. After a mean follow up of 49.25 months (range 16 to 86.12) two patients (2.08%) had chronic pain and one patient (1.04%) had hernia recurrence twenty-six months after surgery. CONCLUSION: The repair of inguinal hernia with PHS is a safe, effective and reproducible method, with low complication and recurrence rates or long term symptoms.