Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware.
Resumo: A inserção do psicólogo em equipes multiprofissionais e interdisciplinares para suporte às equipes de saúde da família, a partir da criação dos Núcleos de Apoio à Saúde da Família em 2008, foi priorizada, ainda que sem um claro perfil para sua atuação. Isso levou ao questionamento das implicações de um trabalho voltado à atenção e gestão para a Psicologia. Objetivou-se analisar o processo de implantação do NASF e a prática dos psicólogos em dois municípios do estado do Rio Grande do Norte. Utilizou-se análise de documentos oficiais e roteiros de entrevistas semiestruturadas distintos, para psicólogos (um do município A e dois do município B) e coordenadores (dois, um de cada município). Pôde-se inferir que a atuação psicológica revela enfoques tradicionais e uma reprodução de atividades de outras instituições. Conclui-se que as diferenças nos processos de implantação dos serviços criam os próprios instrumentos para reversão dessa lógica.
EditorAn outbreak of monkeypox has emerged, with more than 2000 cases confirmed across the globe. While this condition, caused by the Monkeypox virus, a member of the Orthopoxvirus genus, is usually considered a zoonosis, 1 we may be facing a sexually transmissible infection (STI), with yet uncertain consequences.In Portugal, we are seeing many suspected cases a day, most of which have been confirmed. At our department, we have had more than 20 confirmed cases, most of which in individuals with concomitant human immunodeficiency virus infection. The typical presentation we are observing is illustrated by the case of a 43-year-old man, with a 3-day history of painful umbilicated vesicles and ulcers localized to the perianal and genital areas (Fig. 1), with no prodromal symptoms. Centimetric elastic inguinal adenopathies were found, but no extrapelvic skin lesions or adenomegalies were present. He had engaged in unprotected
Data availability statementData sharing not applicable to this article as no datasets were generated or analysed during the current study.
Men who have sex with men (MSM) are at greater risk for sexually transmitted infections (STIs). Data on MSM chlamydia and gonorrhea prevalence estimates and associated risk factors are scarce. To our knowledge, this is the first study to describe the prevalence and the determinants of both chlamydia and gonorrhea infections in MSM in Portugal. We conducted a cross-sectional study using data from 1832 visits to CheckpointLX, a community-based center for screening blood-borne viruses and other STIs in MSM. Overall prevalence of chlamydia or gonorrhea in our sample was 16.05%, with 14.23% coinfection and 40.73% asymptomatic presentation among those testing positive. Anorectal infection was most common for chlamydia (67.26%), followed by urethral (24.78%) and oral (19.47%) infection. Oral infection was most common for gonorrhea (55.63%), followed by anal (51.25%) and urethral (17.50%) infection. In multivariate analyses, young age ( U = 94684, p = 0.014), being foreign-born (χ2 = 11.724, p = 0.003), reporting STI symptoms (χ2 = 5.316, p = 0.021), inhaled drug use (χ2 = 4.278, p = 0.039) and having a higher number of concurrent (χ2 = 18.769, p < 0.001) or total (χ2 = 5.988, p = 0.050) sexual partners were each associated with higher rates of chlamydia or gonorrhea infection. Young and migrant MSM are a vulnerable population to STIs, as are those who use inhaled drugs and those with a higher number of concurrent or total sexual partners. Although Portugal has no guidelines on chlamydia and gonorrhea screening, our results point toward a need for greater awareness about the importance of high-frequency screening for those at increased risk (i.e., every three to six months).
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