Report: A Pox Presenting Without Pox.

ABSTRACT: A man with virally suppressed human immunodeficiency virus (HIV) presented with an erythematous, morbilliform rash without pustules in the setting of fever, fatigue, and myalgias after recent travel to Mexico and Puerto Rico. He was diagnosed with nonvariola orthopoxvirus (monkeypox) infection. This case report highlights an atypical presentation in the 2022 outbreak.

Comparison of methods for measurement of smoking behavior: mouthpiece-based computerized devices versus direct observation.

INTRODUCTION: Understanding factors that influence tobacco use often involves detailed assessment of smoking behavior (i.e., puff topography) via mouthpiece-based, computerized devices. Research suggests that the use of a mouthpiece to evaluate topography may alter natural smoking behavior. This study was designed to compare topography measurement using mouthpiece-based methods (i.e., desktop and portable computerized devices) to methods that do not use a mouthpiece (i.e., direct observation). METHODS: A total of 30 smokers (> or =15 full-flavor or light cigarettes/day) participated in six Latin square-ordered, 2.5-hr experimental sessions that were preceded by at least 8 hr of objectively verified tobacco abstinence (carbon monoxide level < or = 10 ppm). Each session consisted of participants smoking four cigarettes (own brand or Merit ultra-light) ad libitum, conventionally or using a desktop or portable device. Sessions were videotaped using a digital camcorder. RESULTS: All three measurement methods were sensitive to oft-reported brand- and bout-induced changes. Topography measurement differed little between methods (across methods, all r values > .68), and each method was reliable (across bouts within each condition, most r values > .78). In contrast, participants perceived the use of either mouthpiece-based device to alter aspects of their smoking behavior (e.g., increased smoking difficulty, reduced enjoyment, altered cigarette taste; p < .05), relative to video recording only. DISCUSSION: Although direct observational methods may be optimal for measuring certain smoking characteristics, logistical challenges posed by this method likely limit its usefulness. Together, these results suggest that mouthpiece-based devices offer a convenient and useful tool for researchers examining smoking topography.