Mosquito net: a story of the pioneers of tropical medicine

IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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“… 227 , 229 , 233 This finding is supported by a meta-analysis, which also found no increase in septic complications or recurrences. 259 …”

Section: Inguinal Hernia Surgery In Low Resource Settingsmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,449

712

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“…Diseases caused by pathogens transmitted by vectors are not new to the United States or to Europe . After the discovery in the late nineteenth century that mosquitoes could transmit disease‐causing pathogens, and also as residential communities expanded into coastal areas and prime mosquito habitat, organized mosquito control programs in many states were established to control brackish and salt‐water species . From its early beginnings, with few tools but notable successes in Cuba, Panama, Greece and Italy, mosquito control has become a multifaceted procedure with many techniques, inputs and concerns .…”

Section: Introductionmentioning

confidence: 99%

Area‐wide management ofAedes albopictus. Part 2: Gauging the efficacy of traditional integrated pest control measures against urban container mosquitoes

Fonseca

Ünlü

Crepeau³

et al. 2013

Pest. Manag. Sci.

149

162

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BACKGROUND: Aedes (Stegomyia) albopictus (Skuse) is an important disease vector and biting nuisance. During the 2009 active season, six ∼1000-parcel sites were studied, three in urban and three in suburban areas of New Jersey, United States, to examine the efficacy of standard integrated urban mosquito control strategies applied area wide. Active source reduction, larviciding, adulticiding and public education (source reduction through education) were implemented in one site in each county, an education-only approach was developed in a second site and a third site was used as an untreated experimental control. Populations were surveyed weekly with BG-Sentinel traps and ovitraps.RESULTS: A substantial reduction in Ae. albopictus populations was achieved in urban sites, but only modest reductions in suburban sites. Education alone achieved significant reductions in urban adult Ae. albopictus. Egg catches echoed adult catches only in suburban sites.CONCLUSIONS: There are significant socioeconomic and climatic differences between urban and suburban sites that impact upon Ae. albopictus populations and the efficacy of the control methods tested. An integrated pest management approach can affect abundances, but labor-intensive, costly source reduction was not enough to maintain Ae. albopictus counts below a nuisance threshold. Nighttime adult population suppression using truck-mounted adulticides can be effective. Area-wide cost-effective strategies are necessary. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

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“…The term mosquito net dates from the mid‐eighteenth century; however, the use of such devices has been dated to prehistoric times [16]. Mosquito nets vary in their construction, but the most common polymer types are cotton, polyethylene, nylon, and polyester [17]. To stop mosquitoes the pore size must be smaller than 1.2 mm; however, many nets use a pore size of 0.6 mm in order to stop other biting insects [17].…”

Section: Introductionmentioning

confidence: 99%

“…Mosquito nets vary in their construction, but the most common polymer types are cotton, polyethylene, nylon, and polyester [17]. To stop mosquitoes the pore size must be smaller than 1.2 mm; however, many nets use a pore size of 0.6 mm in order to stop other biting insects [17]. In recent years, a number of studies in developing countries have examined the use of locally available mosquito net, of various polymers, for hernia repair [4–7, 18].…”

Section: Introductionmentioning

confidence: 99%