[Monkeypox: Important facts for the ophthalmologist]. / Variole du singe : les points importants pour l'ophtalmologiste.

The current monkeypox virus (MPXV) outbreak, raging since May 2022, is the largest ever observed on a world-wide scale. Despite previously being endemic in west and central Africa with a mortality rate of up to 10%, it remained a neglected tropical disease. Along with other recent pandemics gaining much attention, this MPXV outbreak has provided an opportunity to improve our understanding of its physiopathology and better define management strategies, particularly in patients with more serious disease. From the ophthalmologist's perspective, eyelid involvement and conjunctivitis or keratoconjunctivitis are frequently observed and may precede systemic signs or even remain the major site of involvement. While the course of MPXV keratoconjunctivitis is most often favorable, severe cases pose a functional threat, in particular for immunocompromised patients. This review provides an overview of MPXV pathophysiology, diagnosis and treatment, as well as considerations for prevention of transmission. During such an epidemic, the ophthalmologist can be the first to diagnose MPXV, treat the ocular involvement, and set up adequate preventative measures in collaboration with infectious disease specialists.

A systematic review and clinical atlas on mucocutaneous presentations of the current monkeypox outbreak: With a comprehensive approach to all dermatologic and nondermatologic aspects of the new and previous monkeypox outbreaks.

Monkeypox is a zoonotic disease, endemic in central and west African regions, and has re-emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of mucocutaneous, as well as systemic symptoms of the disease. We searched four main online databases with the keywords "monkeypox" and "Orthopoxvirus". A total of 46 articles were included, with a cumulative number of 1984 confirmed cases. Patients were predominantly men who have sex with men, who were mostly in their 30s, with a history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular, pustular or pseudo-pustular, vesicular-umbilicated and papular lesions were the most common, mainly presenting asynchronously, with less than 10 lesions on each patient. Almost all patients also reported systemic manifestations, namely fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis, and proctitis. Sexual contact is the main pathway of transmission in the current outbreak, with viral shedding in bodily fluids playing a key role. We've compared these idiosyncratic findings of the new outbreak with previous outbreaks. We've also gathered and categorized images from our included studies to make a "clinical atlas" for this "new" face of monkeypox, which can be of utmost importance for clinicians to be familiarized with, and have a clear picture of monkeypox for their differential diagnoses.

A Case Report of Monkeypox in an Adult Patient from Italy: Clinical and Dermoscopic Manifestations, Diagnosis and Management.

Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.

Does Social Distancing Matter for Infectious Disease Propagation? An SEIR Model and Gompertz Law Based Cellular Automaton.

In this paper, we present stochastic synchronous cellular automaton defined on a square lattice. The automaton rules are based on the SEIR (susceptible → exposed → infected → recovered) model with probabilistic parameters gathered from real-world data on human mortality and the characteristics of the SARS-CoV-2 disease. With computer simulations, we show the influence of the radius of the neighborhood on the number of infected and deceased agents in the artificial population. The increase in the radius of the neighborhood favors the spread of the pandemic. However, for a large range of interactions of exposed agents (who neither have symptoms of the disease nor have been diagnosed by appropriate tests), even isolation of infected agents cannot prevent successful disease propagation. This supports aggressive testing against disease as one of the useful strategies to prevent large peaks of infection in the spread of SARS-CoV-2-like diseases.

El pensamiento antivacuna de Alfredo Helsby Hazell: controversias y debates a fines del siglo XIX e inicios del siglo XX en Chile / Alfredo Helsby Hazell's antivaccine view: controversies and debates at the end of the XIX century and the beginning of the XX century in Chile

Resumen El objetivo central de este artículo, es reconstruir los principales argumentos contrarios a la vacunación que circularon en Chile durante fines del siglo XIX e inicios del siglo XX. Para ello, estudiaremos la figura de Alfredo Helsby Hazell, quien fue el principal opositor que tuvo la vacuna en Chile y publicó diversos escritos en los que desarrolló y difundió sus ideas. A través de éstos, observamos que Helsby argumentó su rechazo a la vacunación a partir de la defensa del higienismo y de la desconfianza respecto de las explicaciones de carácter científico que se comenzaron a difundir a partir de la teoría de los gérmenes. Ello se articuló con la defensa de la salud como un ámbito privado de acción, criticando la intervención del Estado en dichas materias.

Abstract This article reconstructs the main arguments against vaccination that circulated in Chile during the late nineteenth and early twentieth centuries. For this purpose, we will study the figure of Alfredo Helsby Hazell, who was the primary opponent of vaccination in Chile and published several writings in which he developed and disseminated his ideas. We observe that Helsby argued his rejection of vaccination from the defence of hygienism and distrust of the scientific explanations that began to spread from the germ theory. This was articulated with the defence of health as a private sphere of action, criticizing the intervention of the State in such matters.

[The frequency of positive results of serological tests against SARS-CoV-2 in healthcare workers in Upper Silesia Metropolitan Area, Poland]. / Czestosc pozytywnych wyników testów serologicznych przeciw SARS-CoV-2 u personelu medycznego Aglomeracji Górnoslaskiej.

BACKGROUND: Silesia is one of the regions in Poland most affected by the COVID-19 epidemic. The high number of infections among the inhabitants of the region increases the already high risk of infection of SARS-CoV-2 virus of medical workers who, due to their work, are more likely to be exposed to people with SARS-CoV-2 than people from the general population. The aim of this study is to assess the prevalence of SARS-CoV-2 infection among healthcare workers in the Upper Silesia Metropolitan Area based on the results of a seroepidemiological study. MATERIAL AND METHODS: The seroepidemiological study was carried out in October- November 2020 among the inhabitants of the Upper Silesia Metropolitan Area (including medical professionals who were selected, creating a research group of healthcare workers). Apart from the questionnaire examination necessary to determine the declared symptoms, circumstances and risk factors conducive to infection, the level of specific antibodies against the SARS-CoV-2 virus in the IgG and IgM class was assessed. RESULTS: In the study participated 575 people declaring their medical profession. A positive test for the presence of IgG antibodies was confirmed in 19.1% of the respondents, while a positive test for IgM concerned 4.3% of the subjects. The most common positive results indicating infection with the SARS-CoV-2 virus concerned people declaring prior contact with an infected person (p = 0.001) and those undergoing quarantine (p < 0.0001). CONCLUSIONS: The frequency of SARS-CoV-2 virus infections in medical personnel in the Upper Silesia Metropolitan Area, assessed on the basis of a positive IgG antibody test result, was 16.1-22.5%. Med Pr. 2022;73(2):125-33.

Lessons from the 1656 Neapolitan Plague: Something to learn for the current coronavirus Pandemic?

In the spring of 1656, an epidemic of bubonic plague suddenly fell on Naples, the capital of the Kingdom of the Two Sicilies. The epidemic had put a strain on the government authorities, forcing them to take sometimes drastic measures but, in most cases, scarcely decisive. The current health emergency caused by Covid-19 disease has many similarities with the epidemics of the past. Here we report the parallelism among plague and Covid-19 in several respects. Taking as a paradigm the plague epidemic of Naples of 1656, we can easily understand how history, showing us how past epidemics were managed and overcome, even with the intrinsic differences due to the limits of time and scientific progress, can still give us a useful lesson to face the present.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.

Challenges of intensive care and anesthesiology related to COVID-19 pandemic. Practical considerations / [Az aneszteziológiai és intenzív ellátás kihívásai a COVID­19-fertozéssel kapcsolatban. Gyakorlati ajánlás]

Due to the coronavirus epidemic, healthcare systems face growing challenges all around the world nowadays. These challenges are the most critical in the field of intensive treatment and anesthesiology. One of the most important prerequisites of effective critical care treatment is preserving the involved healthcare workers from the infection, by providing them with detailed practical advices on the preventive measures and treatment strategies. The aim of the present review is to summarize the most important related knowledge available from previous experiences. Orv Hetil. 2020; 161(17): 652­659.

[Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review]. / Assurer les soins aux patients souffrant de troubles psychiques en France pendant l'épidémie à SARS-CoV-2.

OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France. RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.

The dissemination of COVID-19: an expectant and preventive role in global health

Backgroung: Coronaviruses (CoV) make up a large family of viruses, known since the mid-1960s, which received this name due to the spikes on its surface, which resemble a crown (from the Latin corona). CoV infections can cause everything from a common cold to severe respiratory syndromes, such as severe acute respiratory syndrome (SARS-CoV) and Middle Eastern respiratory syndrome (MERS-CoV).COVID-19 (SARS-CoV2) is a new variant of the coronavirus, and its isolation occurred in China on January 7th, 2020. COVID-19 has stood out with a high impact on public health due to the high number of cases with infection in a short period of time. However, it is possible to observe that 17% of patients confirmed with COVID-19 have severe infections and about 2.5% of these patients die. Current studies have shown that the number of mild and asymptomatic cases may be even greater. Thus, the challenges for controlling unreported cases of patients with mild symptoms that are spreading the virus and interfering with the magnitude and real data of the cases stand out. The transmission of the coronavirus occurs between humans, and it can occur from person to person through the air, through coughing or sneezing, by touching or shaking hands or by contact with contaminated objects or surfaces, followed by contact with the mouth, nose or eyes. Given the fluctuation in the incidence and the lethality rate, it is essential to stand out the precepts of health promotion in search of reorienting hygiene practices, considering that there is validity in health care models, still with a curative approach and the current situation experienced by the world population requires a preventive stance.(AU)

Os coronavírus (CoV) compõem uma grande família de vírus, conhecidos desde meados da década de 1960, que receberam esse nome devido às espículas na sua superfície, que lembram uma coroa (do latim corona). As infecções pelo CoV podem causar desde um resfriado comum até síndromes respiratórias graves, como a síndrome respiratória aguda grave (SARS-CoV) e a síndrome respiratória do Oriente Médio (MERS-CoV). O COVID-19 (SARS-CoV2) é nova variante do coronavírus, sendo que o seu isolamento ocorreu na China em 07/01/2020. O COVID-19 tem se destacado com alto impacto na saúde pública devido ao elevado número de casos com a infecção em um curto período de tempo. Entretanto, é possível observar que apenas 17% dos pacientes confirmados com COVID-19 apresentam infecções graves e cerca de 2,5% destes pacientes morrerem. No entanto, os estudos atuais tem evidenciado que o número de casos leves e assintomáticos podem ser ainda maiores. Dessa forma, destacam-se os desafios para o controle dos casos não notificados de pacientes com sintomas leves que estão espalhando o vírus e interferindo na magnitude e nos dados reais dos casos. A transmissão do coronavírus acontece entre humanos, podendo ocorrer de pessoa a pessoa pelo ar, por meio de tosse ou espirro, pelo toque ou aperto de mão ou pelo contato com objetos ou superfícies contaminadas, seguido pelo contato com a boca, nariz ou olhos. Dada a oscilação da incidência e da taxa de letalidade reforça-se a importância dos preceitos da promoção da saúde em busca da reorientação de práticas de higiene, considerando que há vigência nos modelos assistenciais em saúde, sendo hegemônico o curativismo e a atual situação vivenciada pela população mundial exige postura preventiva.

Esporotricose brasileira: desdobramentos de uma epidemia negligenciada / Brazilian sporotrichosis: development of a neglected epidemic

A esporotricose é uma micose subcutânea de distribuição mundial, sendo observada em surtos de proporções variáveis, com predominância em áreas de clima temperado e tropical. Algumas áreas de endemicidade já foram relatadas. No Brasil, seus agentes etiológicos encontraram não só condições climáticas e estruturais ideais, mas também fontes de infecções extremamente eficientes. Nas últimas décadas, o país tem observado um aumento exponencial no número de casos de esporotricose humana e animal. Esse aumento e o surgimento de resistência aos antifúngicos tornam a situação alarmante. Apesar de essa epidemia se perpetuar há anos, existem poucas políticas de saúde no Brasil para o controle dos casos de esporotricose humana e animal, principalmente na atenção primária à saúde. Assim, intervenções sociais, ambientais e populacionais devem ser feitas para conter essa epidemia negligenciada.

Sporotrichosis is a subcutaneous mycosis with a worldwide distribution, which has been observed in outbreaks of variable proportions in all continents, with predominance in temperate and tropical climate zones. Some areas of endemicity have already been reported. In Brazil, its etiological agents found not only ideal climatic and structural conditions, but also extremely efficient sources of infections. In the last decades, the country has suffered an exponential increase in the number of human and animal cases of sporotrichosis. This increase, combined with the emergence of antifungal resistance makes the situation alarming. Although this epidemic has been perpetuating for years, there are few health policies in Brazil to control it/the disease, especially in primary health care. Therefore, social, environmental and population-based interventions should be organized in order to contain this neglected epidemic.

Epidemia globaldde enfermedades vasculares cronicas: un nuevo paradigma y desafio / Global epidemic of chronic vascular illnesses: A new paradigm and challenge

A nivel mundial, está ocurriendo un proceso de transición epidemiológica con un incremento de la morbilidad y la mortalidad por enfermedades no transmisibles y aunque el fenómeno es global es más acelerado en los países emergentes. Entre estas enfermedades se destacan la enfermedad cardio-vascular, la enfermedad cerebrovascular, la hipertensión arterial, la diabetes mellitus , la macroangiopatía y la enfermedad renal crónica. Estas enfermedades tienen en común que en su origen, progresión a la cronicidad y en sus complicaciones está presente el daño vascular y comparten los mismos factores de riesgo. En este artículo, se analiza la morbilidad, mortalidad y tendencia de estas enfermedades, los principales riesgos y la transición de éstos que están influyendo en este problema de salud epidémico. Se propone un nuevo paradigma integrador de y un enfoque para su prevención.

An epidemiological transition is ocurring throughout the world, leading to an increased morbidity and mortality by non-communicable diseases; in despite of the global characteristic of this phenomenon it is more accelerated in the emerging countries. Cardiovascular disease, cerebrovascular disease, diabetes mellitus, hypertension, macroangiopathy and chronic renal disease are among the main diseases. These diseases have in common that in their origin, progression to chronicity or their complications the vascular damage is presented and on the other hand shares the same risk factors. In this article is analysed the morbidity, mortality and the tendency of these diseases and the risks and transition risks that may influence in this epidemic health problem. A new paradigm integrating the concept of chronic vascular disease and estrategies for its prevention is proposed.

Desde las fuerzss mágicas hasta roberto koch: un enfoque epidemiológico de la tuberullosis

Desde tiempos inmemoriales, la tuberculosis, la "muerte blanca", ha sido una enfermedad que ha causado grandes daños a la Humanidad. Dado que se considera una epidemia, cuando no pandemia, analizamos el trayecto histórico de esta enfermedad, considerada una enfermedad transmisible. Veremos sus causas, mediante una revisión histórica, y los científicos que se dedicaron a estudiarla hasta llegar al descubrimiento que hiciera Roberto Koch (1843-1910) (Nobel en 1905) del bacilo. Las medidas preventivas y curativas también son revisadas hasta llegar al descubrimiento de la vacuna BCG (Bacilo Calmette-Guérin) en tiempos modernos, en 1919, lo cual debió ser el fin de tan temible flagelo. Empero, hoy en día la tenemos entre nosotros, recrudecida y virulenta. Es la llamada "enfermedad de la pobreza", enfermedad social de las masas. Así desde las Fuerzas Mágicas hasta la actualidad contendemos con la tuberculosis, enfermedad conocida por babilonios y egipcios y sufrida por la Humanidad en pleno siglo XXI.

Since the beginning of History tuberculosis, "the white death", has been a disease that has caused enormous impairment to Humanity. Since it is considered an epidemic, if not pandemic, we review the historical pathway of this illness, considered a transmissible disease. We will review its causes through history and the scientists who devoted themselves to study it, until the discovery of Robert Koch (1843-1910) (Nobel, 1905) of the bacillus. The preventive and curative measures are also revised until we get to the discovery of the vaccine BCG (Calmette-Guérin bacillus) in our modern age, 1919 to be precise, supposedly to be the end of this scourge. Nevertheless, nowadays we have the disease among us, increased and virulent. This is the so called "sickness of the poverty", social sickness of the masses. So, from the "Magic Forces" up to our age, we contend with TB, sickness already know by Egyptians and Babylonians and suffered still by Humanity in our newborn XXI Century.