Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Determination of damage caused by different populations of Diloboderus abderus (Coleoptera: Scarabaeidae) larvae on wheat

Wheat (Triticum aestivum L.) is the most widely cultivated cereal crop worldwide because it is an important food source for humans. South America has long been associated with wheat production and export. Given the increased application of no till in the last decades, the scarabid Diloboderus abderus has become the main soil pest of this crop. The larvae of this insect (white grubs) feed on roots, causing plant weakening and death. The aim of this work was to determine the relationship between the soil population of D. abderus larvae and the number of established wheat plants. In a plot cultivated with the wheat cultivar Don Mario Algarrobo at a seeding rate of 130 kg ha-1 and with high population levels of this pest, 1-m2 sites with 20-39; 40-60; 80-100; 120-160 and or 200-240 plants were established. At the tillering phenological stage, the number of tillers per plant and of insect larvae in each subplot was counted. The results showed a significant reduction in plant density with increasing soil larval population. The crop counterbalanced the reduction in plant number by increasing the tiller number per unit area. The present work shows that population levels above 11 larvae m-2 generate a significant reduction in the number of wheat plants established in the crop.Fil: del Valle, Eleodoro Eduardo. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; ArgentinaFil: Mayer, Gabriel F.. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Mazuquín, Gabriel. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Nari, Pablo. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Toffoli Arnaudo, Guillermo Daniel. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Imvinkelried, Horacio Omar. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentin

El campo médico argentino y su mirada al tribadismo, 1936-1955 The medical argentine field and its look on the tribadism, 1936-1955

Este artículo describe y analiza la articulación discursiva sobre el lesbianismo en el campo médico argentino entre 1936 y 1955. Las "verdades" de la medicina poseen una fuerza normativa que constituyen un lugar privilegiado para propiciar la aplicación del modelo heterosexual e imponer esta visión al resto de la sociedad. En primer lugar esbozaremos los argumentos médicos en el ámbito europeo por ser los referentes más recorridos por la elite médica argentina. Luego, analizaremos las relecturas y apropiaciones realizadas en el contexto argentino articulándolas con el modelo hegemónico heterosexual de feminidad.<br>This article describes and analyzes the discursive articulation on the lesbianism in the medical Argentine field between 1936 and 1955. The "truths" of the medicine possess a normative force which constitutes a suitable place to favor the heterosexual model and to impose this point of view to the rest of the society. First we will outline the medical arguments in the European area. They were the most accessed models by the medical Argentine elite. Then, we will analyze the re-readings and appropriations realized in Argentina, articulating them with the hegemonic heterosexual model of femininity

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

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

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