Insecticide resistance of Miami-Dade Culex quinquefasciatus populations and initial field efficacy of a new resistance-breaking adulticide formulation.

Sporadic outbreaks of human cases of West Nile virus (WNV), primarily vectored by Culex quinquefasciatus Say in suburban and urban areas, have been reported since introduction of the virus into Florida in 2001. Miami-Dade County, Florida is part of one of the largest metropolitan areas in the United States, supports Cx. quinquefasciatus year-round, and recently experienced over 60 human cases of WNV during one outbreak. To facilitate more effective integrated vector management and public health protection, we used the Centers for Disease Control and Prevention (CDC) bottle bioassay method to evaluate the susceptibility of adult Cx. quinquefasciatus collected from 29 locations throughout Miami-Dade County to pyrethroid and organophosphate adulticide active ingredients (AIs) used by Miami-Dade County Mosquito Control. We also determined the frequency of the 1014 knockdown resistance (kdr) mutation for Cx. quinquefasciatus from a subset of 17 locations. We detected resistance to two pyrethroid AIs in all tested locations (permethrin: 27 locations, deltamethrin: 28 locations). The 1014F allele was widely distributed throughout all 17 locations sampled; however, 29.4% of these locations lacked 1014F homozygotes even though phenotypic pyrethroid resistance was present. Organophosphate resistance was more variable; 20.7% of the locations tested were susceptible to malathion, and 33.3% of the populations were susceptible to naled. We subsequently conducted a field trial of ReMoa Tri, a recently approved multiple AI adulticide formulation labelled for resistant mosquitoes, against a mixed location field population of Miami-Dade Cx. quinquefasciatus. Average 24-hr mortality was 65.1 ± 7.2% and 48-hr mortality increased to 85.3 ± 9.1%, indicating good control of these resistant Cx. quinquefasciatus. This current study shows that insecticide resistance is common in local Cx. quinquefasciatus but effective options are available to maintain control during active disease transmission in Miami-Dade County.

Frequency of fungal agents identified in sinus samples from patients with clinically suspected rhinosinusitis.

Fungal rhinosinusitis (FRS) is one of the most important rhinosinusoidal disorders, which involves a variety of etiological agents. We carried out a study to determine the frequency of fungal agents in sinus samples from patients with clinically suspected rhinosinusitis (RS). A total of 205 clinical samples were assessed from 174 patients with clinically suspected RS, of which 48 were positive for microscopic examination and culture, 47 were positive for direct examination but negative by culture, 4 were negative for direct examination but positive by culture, and 106 were negative for both methodologies. The main fungal agents isolated were Aspergillus spp. (32.7%), followed by Schizophyllum commune (28.8%). Sensitivity and specificity of the direct examination were 92.3% and 69.3%, respectively, and concordance between the direct examination and culture was 48.4%. This study indicated that both Aspergillus and S. commune appear to be the most important agents involved in the development of FRS.

Coagulopatía asociada a trauma / Coagulopathy associated with trauma

La presencia de hemorragias, no ocasionadas por lesiones de estructuras vasculares, que se pueden controlar mecánicamente, constituyen coagulopatías y es una de las situaciones que pueden encontrar un cirujano en pacientes críticos o politraumatizados, que aumentan significativamente la morbilidad llegando la mortalidad al 87% 7El conocimiento de los factores relacionados con la etiopatogenia de las coagulopatías, nos permitirá la aplicación de medidas útiles y el correcto manejo por parte del equipo médico, del paciente traumatizado.

The presence of hemorrhage not caused by lesion of vascular structure wich can be controlled mechanically constitute coagulopathies and is one of the problems that a surgeon can find in critical patients or polytraumatized wich raise the morbility, reaching up to an 87% of mortality.The knowledge of the factors related with the etiopatogenia of the coagulopathies will allow us the application of useful standards and the right management by the medical staff of the politraumatized patient.