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1.
Emerg Infect Dis ; 29(11): 2353-2357, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37796277

RESUMEN

We assessed tecovirimat treatment equity for 3,740 mpox patients in New York, New York, USA, during the 2022 mpox emergency; 32.4% received tecovirimat. Treatment rates by race/ethnicity were 38.8% (White), 31.3% (Black/African American), 31.0% (Hispanic/Latino), and 30.1% (Asian/Pacific Islander/other). Future public health emergency responses must prioritize institutional and structural racism mitigation.


Asunto(s)
Antivirales , Mpox , Humanos , Hispánicos o Latinos/estadística & datos numéricos , Mpox/epidemiología , Mpox/etnología , Mpox/terapia , New York/epidemiología , Factores Socioeconómicos , Factores Raciales/estadística & datos numéricos , Blanco/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Asiático Americano Nativo Hawáiano y de las Islas del Pacífico/estadística & datos numéricos , Antivirales/uso terapéutico
3.
Aten Primaria ; 55(10): 102680, 2023 10.
Artículo en Español | MEDLINE | ID: mdl-37343414

RESUMEN

Monkeypox (MPOX) is a viral zoonosis endemic in West or Central African countries that is sporadically exported to another area. In May 2022, a global outbreak of MPOX smallpox began to occur in several countries in Europe and North America. Most of the reported cases are identified at the outpatient level and mainly affect men who have sex with men (MSM). Transmission is by close contact with lesions, body fluids, respiratory secretions or contaminated material from an infected person or animal. The clinical picture is similar to human smallpox, with less severity. Mild, self-limiting skin involvement predominates after 2-4 weeks. In MSM, atypical skin lesions appear due to the mode of infection. Severe forms or complications may appear in certain risk groups. The case fatality rate is 3%-6% depending on the clade responsible. The diagnosis of suspicion is confirmed by detection of the virus from exudates of lesions or scabs, with nucleic acid amplification techniques by conventional or real-time PCR. Clinical management in most cases is performed in primary care (PC), by monitoring the main symptoms. Between 5-10% require hospital management and there are some specific antiviral treatment options. Human smallpox vaccines protect against MPOX and are used as pre- and post-exposure prophylaxis for persons at risk. Measures to reduce exposure to the virus are the main MPOX prevention strategy. In addition, the role of the family physician is key to controlling the spread of MPOX through active surveillance and early diagnosis of the disease.


Asunto(s)
Mpox , Minorías Sexuales y de Género , Viruela , Animales , Masculino , Humanos , Homosexualidad Masculina , Mpox/diagnóstico , Mpox/epidemiología , Mpox/terapia , Viruela/diagnóstico , Viruela/prevención & control , Atención Primaria de Salud
5.
Front Immunol ; 14: 1132250, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37026012

RESUMEN

On 23rd July 2022, the World Health Organization (WHO) recognized the ongoing monkeypox outbreak as a public medical crisis. Monkeypox virus (MPV), the etiological agent of monkeypox, is a zoonotic, linear, double-stranded DNA virus. In 1970, the Democratic Republic of the Congo reported the first case of MPV infection. Human-to-human transmission can happen through sexual contact, inhaled droplets, or skin-to-skin contact. Once inoculated, the viruses multiply rapidly and spread into the bloodstream to cause viremia, which then affect multiple organs, including the skin, gastrointestinal tract, genitals, lungs, and liver. By September 9, 2022, more than 57,000 cases had been reported in 103 locations, especially in Europe and the United States. Infected patients are characterized by physical symptoms such as red rash, fatigue, backache, muscle aches, headache, and fever. A variety of medical strategies are available for orthopoxviruses, including monkeypox. Monkeypox prevention following the smallpox vaccine has shown up to 85% efficacy, and several antiviral drugs, such as Cidofovir and Brincidofovir, may slow the viral spread. In this article, we review the origin, pathophysiology, global epidemiology, clinical manifestation, and possible treatments of MPV to prevent the propagation of the virus and provide cues to generate specific drugs.


Asunto(s)
Mpox , Humanos , Antígenos Virales , Antivirales , Cidofovir , Mpox/diagnóstico , Mpox/epidemiología , Mpox/terapia , Prevalencia
6.
Front Public Health ; 11: 1144325, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36969617

RESUMEN

Background: Monkeypox (mpox), a zoonotic viral infection, poses a global threat that is being acknowledged at the national and international levels. This systematic review aims to identify and characterize interventional clinical trials for mpox. Method: All interventional clinical trials registered at ClinicalTrials.gov for mpox were searched up to January 6, 2023. We described the characteristics of interventional clinical trials, and drug interventions (including drugs and vaccines). Results: As of January 6, 2023, there were 10 clinical trials in the ClinicalTrials.gov registry that met our criteria. Most of the interventional clinical trials were focused on the treatment (N = 4, 40%) and prevention (N = 4, 40%) of mpox. From the 10 trials, 50% used random treatment allocation, and six (60%) chose the parallel assignment intervention model. All 10 studies were blinded, and six were open-label blinded. The largest proportion of the clinical trials (N = 4, 40%) were registered in Europe, followed by America (N = 3, 30%) and Africa and others (N = 3, 30%). The JYNNEOS vaccine (40%), followed by Tecovirimat (30%) were the most frequently studied drugs used against mpox. Conclusion: A limited number of clinical trials have been registered on ClinicalTrials.gov since the first case of mpox was reported. Therefore, there is an urgent need to conduct large-scale randomized clinical trials to assess the safety and efficacy of the drugs and vaccines being used against the mpox virus.


Asunto(s)
Mpox , Humanos , Mpox/terapia , África , Benzamidas , Bases de Datos Factuales , Europa (Continente)
7.
Gynecol Obstet Fertil Senol ; 51(5): 284-288, 2023 05.
Artículo en Francés | MEDLINE | ID: mdl-36931598

RESUMEN

Although the 2022 Monkeypox virus epidemic mostly affects males, particularly men having sex with men, transmission to women may also occur. In case of MPXV infection in pregnancy, transmission to the fetus can result in very severe disease. Thus, caregivers should be aware of the measures to be taken according to the available evidence, in case of exposure or in case of symptoms particularly skin rash compatible with this diagnosis in a pregnant woman. Pregnant women should have access to vaccination, vaccinia immunoglobulin or antiviral medications as required.


Asunto(s)
Mpox , Masculino , Humanos , Femenino , Embarazo , Mpox/terapia , Mpox/tratamiento farmacológico , Monkeypox virus , Vacunación , Antivirales/uso terapéutico
11.
Int J Gynaecol Obstet ; 161(3): 738-743, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36377907

RESUMEN

The present study aimed to review monkeypox infection during pregnancy: its epidemiology and etiology, transmission, clinical manifestations and complications, diagnosis, management, antenatal testing and delivery, prevention, awareness, and recommendations. Monkeypox can spread via vertical transmission. The usual clinical symptoms include fever, rash (vesicles, crust), new genital lesions, or sore throat. It is only recommended to use cidofovir in pregnant patients when they are severely infected with monkeypox. All woman who are at high risk of exposure for monkeypox need to be vaccinated with the smallpox vaccine regardless of their pregnancy status. Monitoring includes regular non-stress test monitoring in addition to ultrasound performed at various stages of pregnancy. High index of suspicion, informed physicians, reporting of cases, and support of research are all needed for the management of monkeypox infection during pregnancy.


Asunto(s)
Mpox , Médicos , Vacuna contra Viruela , Humanos , Femenino , Embarazo , Mpox/diagnóstico , Mpox/epidemiología , Mpox/terapia , Vacuna contra Viruela/efectos adversos , Cidofovir , Transmisión Vertical de Enfermedad Infecciosa
12.
Adv Exp Med Biol ; 1410: 7-11, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36396927

RESUMEN

Monkeypox is a global health issue caused by the monkeypox virus. It can spread from person to person through respiratory secretions, direct exposure to dermatological lesions of infected patients, or exposure to contaminated objects. It is more common in homosexual men, and most patients are asymptomatic. The gold standard for diagnosis is a real-time polymerase chain reaction. In the absence of testing facilities, clinicians rely upon detailed history to exclude other causes of fever with rashes. Initially, there is a prodrome phase of a few days, which is followed by the appearance of rashes. The dermatological manifestations are in the form of an exanthematous rash, which transforms through a macular, papular, and vesicular phase and disappears after crusting in approximately 3 weeks. There can be associated lymphadenopathy in these patients. Respiratory manifestations include nasal congestion and shortness of breath that may result in secondary bacterial infections. Additionally, patients can have neurological involvement in the form of encephalitis. Furthermore, ocular involvement can occur in the form of conjunctivitis, keratitis, and corneal ulceration. Other symptoms can include diarrhea, vomiting, myalgia, and backache. Since most patients do not require hospitalization, the approach to treatment is mainly vigilant monitoring, antiviral therapy, and management of associated complications.


Asunto(s)
Mpox , Mpox/complicaciones , Mpox/diagnóstico , Mpox/fisiopatología , Mpox/terapia , Humanos , Monkeypox virus/genética , Monkeypox virus/aislamiento & purificación , Monkeypox virus/patogenicidad , Exantema/etiología , Exantema/virología , Linfadenopatía/etiología , Linfadenopatía/virología , Disnea/etiología , Disnea/virología , Encefalitis/etiología , Encefalitis/virología , Conjuntivitis/etiología , Conjuntivitis/virología , Queratitis/etiología , Queratitis/virología , Úlcera de la Córnea/etiología , Úlcera de la Córnea/virología
13.
Ann Emerg Med ; 81(1): 20-30, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36117012

RESUMEN

The outbreak of monkeypox in May and June 2022 is the largest outside of central and western Africa since the 2003 outbreak in the United States. Monkeypox, like smallpox, is caused by an orthopoxvirus, though its clinical manifestations tend to be less severe. It is characterized by a prodromal flu-like illness with lymphadenopathy followed by a centrifugally spreading rash, sometimes involving the face, palms, soles, and oral mucosa. Although the vast majority of cases resolve with symptomatic management, a small number of patients can suffer severe outcomes including, but not limited to, secondary bacterial skin infections, pneumonitis, ocular sequelae, encephalitis, hypovolemia, and death. Local, state, and federal health authorities should be involved in the care of people under investigation for this illness. With confirmed cases worldwide and the possibility of community spread, emergency clinicians need to be aware of the manifestations and management of this disease, both to treat those with the disease as well as to provide education to those exposed and at risk of infection.


Asunto(s)
Exantema , Mpox , Humanos , Estados Unidos/epidemiología , Mpox/diagnóstico , Mpox/epidemiología , Mpox/terapia , Brotes de Enfermedades , África Occidental , Ojo
14.
Arq. ciências saúde UNIPAR ; 27(3): 1173-1182, 2023.
Artículo en Portugués | LILACS | ID: biblio-1425453

RESUMEN

Objetivo: descrever o processo de condução de um caso com manifestação oftálmica pela mpox, destacando o trabalho da enfermagem na prevenção de complicações da doença. Método: relato de experiência da condução de um caso de mpox ocorrido em setembro de 2022 com manifestação oftálmica. Resultados: a pronta identificação da complicação oftálmica, com a presença de conjuntivite e edema palpebral, apresentada por um paciente com suspeita de mpox pela equipe de enfermagem da vigilância epidemiológica durante as ações de monitoramento, e o envolvimento da equipe com outras equipes de diversos níveis da assistência à saúde permitiram a instituição precoce do tratamento com antiviral recomendado pelo Ministério da Saúde, o que contribuiu para um melhor desfecho. Conclusão: é importante que se dissemine o conhecimento sobre as manifestações oftálmicas associadas à mpox para que a equipe de enfermagem, que atua nos diversos níveis de atenção à saúde, esteja atenta para implementar, de forma precoce, medidas de prevenção, diagnóstico e tratamento adequados.


Objective: to describe the process of conducting a case with ophthalmic manifestation by mpox, highlighting the work of nursing in preventing complications of the disease. Method: experience report of managing a case of mpox that occurred in September 2022 with ophthalmic manifestation. Results: the prompt identification of the ophthalmic complication, with the presence of conjunctivitis and eyelid edema, presented by a patient with suspected mpox by the epidemiological surveillance nursing team during monitoring actions and the team's involvement with other teams from different levels of the health care allowed the early initiation of antiviral treatment recommended by the Ministry of Health, which contributed to a better outcome. Conclusion: it is important to disseminate knowledge about ophthalmic manifestations associated with mpox for the nursing team that works at different levels of health care to be attentive to implement preventive measures, diagnosis and adequate and early treatment.


Objetivo: describir el proceso de manejo de un caso con manifestación of- talmológica por mpox, destacando la labor de enfermería en la prevención de complica- ciones de la enfermedad. Material y método: relato de experiencia de manejo de un caso de mpox ocurrido en septiembre de 2022 con manifestación oftálmica. Resultados: la rápida identificación de la complicación oftálmica, con la presencia de conjuntivitis y edema de párpados, presentada por un paciente con sospecha de mpox por el equipo de enfermería de vigilancia epidemiológica durante las acciones de monitoreo y la partici- pación del equipo con otros equipos de diferentes niveles de la asistencia sanitaria per- mitió el inicio precoz del tratamiento antiviral recomendado por el Ministerio de Salud, lo que contribuyó a un mejor resultado. Conclusión: es importante difundir el conoci- miento sobre las manifestaciones oftálmicas asociadas a la viruela del mono para que el equipo de enfermería que actúa en los diferentes niveles de atención a la salud esté atento a implementar medidas preventivas, diagnósticas y de tratamiento adecuado y precoz.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Vigilancia Sanitaria , Mpox/diagnóstico , Mpox/prevención & control , Mpox/terapia , Manifestaciones Oculares , Antivirales , Monitoreo del Ambiente/instrumentación , Enfermería , Conjuntivitis/diagnóstico , Conjuntivitis/prevención & control , Conjuntivitis/terapia , Informes de Casos como Asunto , Investigación sobre Servicios de Salud
18.
J R Soc Med ; 115(10): 384-389, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36342045

RESUMEN

The monkeypox virus outbreak continues to evolve worldwide. While most people recover without treatment, primary care clinicians may be the first point of contact for those affected. Prompt assessment, diagnosis, isolation, treatment and prophylaxis will reduce the risk of community transmission. The current public health advice is to test suspected cases and monitor close contacts. If individuals test positive for the monkeypox virus, self-isolation at home is recommended for most people with mild symptoms. If patients report severe symptoms, referral and admission to hospital will be needed, where further interventions such as antivirals may be administered. The infection can spread through close contact; therefore, healthcare professionals must take precautions, such as using appropriate personal protective equipment for possible or probable cases.


Asunto(s)
Mpox , Humanos , Mpox/diagnóstico , Mpox/epidemiología , Mpox/terapia , Brotes de Enfermedades/prevención & control , Equipo de Protección Personal , Personal de Salud , Atención Primaria de Salud
19.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-49180

RESUMEN

Documento produzido pelo Ministério da Saúde reúne as principais orientações técnicas sobre medidas de prevenção, controle, diagnóstico e tratamento de Monkeypox para trabalhadores da saúde, gestores e demais interessados.


Asunto(s)
Atención a la Salud , Salud Materno-Infantil , Mpox/diagnóstico , Mpox/prevención & control , Mpox/terapia , Brasil
20.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(9): 960-966, 2022.
Artículo en Chino | MEDLINE | ID: mdl-36111711

RESUMEN

The guideline for the diagnosis and treatment of monkeypox (2022 edition) issued by National Health Commission of the People's Republic of China introduces the key knowledge of the diagnosis and treatment of human monkeypox (HMPX) and does not systematically introduce the sampling methods and requirements of specimens for HMPX etiology testing and the discrepancy in diagnostic criteria between China and overseas. However, the doctors who are not engaged in dermatology lack understanding of the sampling methods and requirements of specimens for laboratory diagnosis of HMPX, and there are few relevant references available. This article collects the information on the diagnosis and treatment of HMPX, so as to provide a reference for learning, understanding, and application of this guideline.


Asunto(s)
Mpox , China , Humanos , Mpox/diagnóstico , Mpox/terapia
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