Current Status of the Insecticide Resistance in Aedes aegypti (Diptera: Culicidae) from Mexico

The mosquito Aedes aegypti (Diptera: Culicidae) is the primary vector of dengue in Mexico and lately virus Chikungunya, although Aedes albopictus is widely distributed; its role in both diseases’ transmission has not been confirmed. The control of mosquitoes in Mexico includes source reduction consisting in the elimination of containers that are favorable sites for oviposition and development of the aquatic stage. The use of insecticides is to control larvae and adulticides as outdoor ultra-low volume applications and indoor residual spray and more recently impregnated materials. The health department regulates the use of insecticides, and such regulations are revised and adapted over time. Since 1999, the vector control regulations gave preference to the use of pyrethroids, a permethrin-based formulation to control adult forms. This insecticide was used as the only adulticide in Mexico for more than 10 years. The consequences of this actions have evolved in a widespread and strong resistance to other insecticides, mainly pyrethroids. We include in this revision evidence of resistance reported in Ae. aegypti in Mexico

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2